nursing care 2 exam 1

A client who has started therapy for drug-resistant tuberculosis demonstrates understanding of tuberculosis transmission when he says:

"I'll stop being contagious when I have a negative acid-fast bacilli test."

The nursing student learning on a cardiac unit asks the instructor why loss of the "atrial kick" causes a decrease in cardiac output, because the ventricles are still contracting. What is the nursing instructor's best response?

"The atrial contraction fills the ventricles and accounts for nearly one-third of the volume ejected during ventricular contraction."

The client asks the nurse to explain what is meant by a ventricular bigeminy cardiac rhythm. What is the best response by the nurse?

"The rhythm has a normal beat, then a premature beat pattern."

client with chronic obstructive pulmonary disease (COPD) and cor pulmonale is being prepared for discharge. The nurse should provide which instruction?

"Weigh yourself daily and report a gain of 2 lb in 1 day."

cor pulmonale

"heart of the lungs", enlargement of the right ventricle from hypertrophy or dilation or as a secondary response to disorders that affect the lungs

In which grade of COPD is the forced expiratory volume in 1 second (FEV1) greater than 80% predicted?

1

A nurse is assessing the injection site of a client who has received a purified protein derivative test. Which finding indicates a need for further evaluation?

15 mm induration

A patient has missed 2 doses of digitalis. What laboratory results would indicate to the nurse that the patient is within therapeutic range?

2.0 mg/mL

The nurse is educating a patient who will be started on an antituberculosis medication regimen. The patient asks the nurse, "How long will I have to be on these medications?" What should the nurse tell the patient?

6 to 12 months

The goal for oxygen therapy in COPD is to support tissue oxygenation, decrease the work of the cardiopulmonary system, and maintain the resting partial arterial pressure of oxygen (PaO2) of at least ______ mm Hg and an arterial oxygen saturation (SaO2) of at least ___%.

60 mm Hg; 90%

The nurse is assigned the following client assignment on the clinical unit. For which client does the nurse anticipate cardioversion as a possible medical treatment?

A client with atrial dysrhythmias

On auscultation, which finding suggests a right pneumothorax?

Absence of breath sounds in the right thorax

The nurse caring for a 2-year-old near-drowning victim monitors for what possible complication?

Acute respiratory distress syndrome

A nurse is caring for a client with status asthmaticus. Which medication should the nurse prepare to administer?

An inhaled beta2-adrenergic agonist

The nurse knows that electrocardiogram (ECG) characteristics of atrial fibrillation include what?

Atrial rate of 300 to 400

A client with heart failure is having a decrease in cardiac output. What indication does the nurse have that this is occurring?

Blood pressure 80/46 mm Hg

A victim has sustained a blunt force trauma to the chest. A pulmonary contusion is suspected. Which of the following clinical manifestations correlate with a moderate pulmonary contusion?

Blood-tinged sputum

Which statement is true about both lung transplant and bullectomy?

Both procedures improve the overall quality of life of a client with COPD.

A client has been prescribed furosemide 80 mg twice daily. The asymptomatic client begins to have rare premature ventricular contractions followed by runs of bigeminy with stable signs. What action will the nurse perform next?

Check the client's potassium level.

A nurse is caring for a client who has just been diagnosed with lung cancer. What is a cardinal sign of lung cancer?

Cough or change in chronic cough

A patient is undergoing a pericardiocentesis. Following withdrawal of pericardial fluid, which assessment by the nurse indicates that cardiac tamponade has been relieved?

Decrease in central venous pressure (CVP)

After evaluating a client for hypertension, a health care provider orders atenolol, 50 mg P.O. daily. Which therapeutic effect should atenolol have in treating hypertension?

Decreased cardiac output and decreased systolic and diastolic blood pressure

A nurse evaluates a client with a temporary pacemaker. The client's ECG tracing shows each P wave followed by the pacing spike. What is the nurse's best response?

Document the findings and continue to monitor the client

A patient is admitted to the hospital with pulmonary arterial hypertension. What assessment finding by the nurse is a significant finding for this patient?

Dyspnea

A nurse is assessing a client who comes to the clinic for care. Which findings in this client suggest bacterial pneumonia?

Dyspnea and wheezing

The nurse is assessing a client with mitral regurgitation. The nurse expects to note what finding in this client?

Dyspnea, fatigue, and weakness

A nurse is caring for a patient diagnosed with empyema. Which of the following interventions does a nurse implement for patients with empyema?

Encourage breathing exercises.

A client hospitalized with pneumonia has thick, tenacious secretions. Which intervention should the nurse include when planning this client's care?

Encouraging increased fluid intake

A client with chronic obstructive pulmonary disease (COPD) expresses a desire to quit smoking. The first appropriate response from the nurse is:

Have you tried to quit smoking before?

A client with congestive heart failure is admitted to the hospital after reporting shortness of breath. How should the nurse position the client in order to decrease preload?

Head of the bed elevated 45 degrees and lower arms supported by pillows

When caring for a client with acute respiratory failure, the nurse should expect to focus on resolving which set of problems?

Hypercapnia, hypoventilation, and hypoxemia

Asthma is cause by which type of response?

IgE-mediated

The clinical manifestations of cardiogenic shock reflect the pathophysiology of heart failure (HF). By applying this correlation, the nurse notes that the degree of shock is proportional to which of the following?

Left ventricular function

Which community-acquired pneumonia demonstrates the highest occurrence during summer and fall?

Legionnaires disease

The nurse is providing discharge instructions to a client with heart failure preparing to leave the following day. What type of diet should the nurse request the dietitian to discuss with the client?

Low-sodium diet

Which nursing intervention must a nurse perform when administering prescribed vasopressors to a client with a cardiac dysrhythmia?

Monitor vital signs and cardiac rhythm

A client develops cardiogenic pulmonary edema and is extremely apprehensive. What medication can the nurse administer with physician orders that will relieve anxiety and slow respiratory rate?

Morphine sulfate

To evaluate a client's atrial depolarization, the nurse observes which part of the electrocardiogram waveform?

P wave

A nursing instructor is reviewing the parts of an EKG strip with a group of students. One student asks about the names of all the EKG cardiac complex parts. Which of the following items are considered a part of the cardiac complex on an EKG strip?

P wave P-R interval T wave

The client with cardiac failure is taught to report which symptom to the physician or clinic immediately?

Persistent cough

A client who has just had a triple-lumen catheter placed in his right subclavian vein complains of chest pain and shortness of breath. His blood pressure is decreased from baseline and, on auscultation of his chest, the nurse notes unequal breath sounds. A chest X-ray is immediately ordered by the physician. What diagnosis should the nurse suspect?

Pneumothorax

Which term describes the degree of stretch of the ventricular cardiac muscle fibers at the end of diastole?

Preload

Which ECG waveform characterizes conduction of an electrical impulse through the left ventricle?

QRS complex

The nurse analyzes the electrocardiogram (ECG) tracing of a client newly admitted to the cardiac step-down unit with a diagnosis of chest pain. Which finding indicates the need for follow-up?

QT interval that is 0. 46 seconds long

As status asthmaticus worsens, the nurse would expect which acid-base imbalance?

Respiratory acidosis

In chronic obstructive pulmonary disease (COPD), decreased carbon dioxide elimination results in increased carbon dioxide tension in arterial blood, leading to which of the following acid-base imbalances?

Respiratory acidosis

The nurse recognizes which symptom as a classic sign of cardiogenic shock?

Restlessness and confusion

The nurse is placing electrodes for a 12-lead electrocardiogram (ECG). The nurse would be correct in placing an electrode on which area for V1?

Right side of sternum, fourth intercostal space

You are caring for a client status post lung resection. When assessing your client you find that the bubbling in the water-seal chamber for the chest tubes is more than you expected. What should you check when bubbling in the water-seal chamber is excessive?

See if there are leaks in the system.

The nurse is teaching a beginning EKG class to staff nurses. As the nurse begins to discuss the parts of the EKG complex, one of the students asks what the normal order of conduction through the heart is. What order does the nurse describe?

Sinoatrial (SA) node, atrioventricular (AV) node, bundle of His, right and left bundle branches, and the Purkinje fibers

A patient comes to the emergency department with reports of chest pain after using cocaine. The nurse assesses the patient and obtains vital signs with results as follows: blood pressure 140/92, heart rate 128, respiratory rate 26, and an oxygen saturation of 98%. What rhythm on the monitor does the nurse anticipate viewing?

Sinus tachycardia

A nurse is discussing asthma complications with a client and family. What complications should the nurse include in the teaching?

Status asthmaticus Respiratory failure Atelectasis

The patient with a chest tube is being transported to X-ray. Which complication may occur if the chest tube is clamped during transportation?

Tension pneumothorax

A client has been hospitalized for treatment of acute bacterial pneumonia. Which outcome indicates an improvement in the client's condition?

The client has a partial pressure of arterial oxygen (PaO2) value of 90 mm Hg or higher.

A client has a myocardial infarction in the left ventricle and develops crackles bilaterally; 3-pillow orthopnea; an S3 heart sound; and a cough with pink, frothy sputum. The nurse obtains a pulse oximetry reading of 88%. What do these signs and symptoms indicate for this client?

The development of left-sided heart failure

While caring for a client with a chest tube, which nursing assessment would alert the nurse to a possible complication?

The tissues give a crackling sensation when palpated.

Which technique does the nurse suggest to a client with pleurisy while teaching about splinting the chest wall?

Turn onto the affected side.

For a client with advanced chronic obstructive pulmonary disease (COPD), which nursing action best promotes adequate gas exchange?

Using a Venturi mask to deliver oxygen as ordered

The nurse caring for a client with tuberculosis anticipates administering which vitamin with isoniazid (INH) to prevent INH-associated peripheral neuropathy?

Vitamin B6

Which nursing intervention should the nurse perform when a client with valvular disorder of the heart has a heart rate less than 60 beats/min before administering beta-blockers?

Withhold the drug and inform the primary health care provider

A nurse is preparing dietary recommendations for a client with a lung abscess. Which statement would be included in the plan of care?

You must consume a diet rich in protein, such as chicken, fish, and beans."

troponin

a cardiac muscle biomarker; measurement is used as an indicator of heart muscle injury

heart failure (HF)

a clinical syndrome resulting from structural or functional cardiac disorders that impair the ability of a ventricle to fill or eject blood

metabolic syndrome

a cluster of metabolic abnormalities including insulin resistance, obesity, dyslipidemia, and hypertension that increase the risk of cardiovascular disease

acute coronary syndrome

a constellation of signs and symptoms due to the rupture of atherosclerotic plaque and resultant partial or complete thrombosis within a diseased coronary artery; leads to unstable angina or acute myocardial infarction

hypotension

a decrease in blood pressure to less than 100/60 mm Hg that compromises systemic perfusion

implantable cardioverter defibrillator (ICD)

a device implanted into the chest wall to treat dysrhythmias

emphysema

a disease of the airways characterized by destruction of the walls of overdistened alveoli

chronic bronchitis

a disease of the airways defined as the presence of cough and sputum production for at least a combined total of 3 months in each 2 consecutive years

paroxysmal

a dysrhythmia that has a sudden onset and terminates spontaneously; usually of short duration, but may recur

congestive heart failure (CHF)

a fluid overload condition (congestion) associated with heart failure

asthma

a heterogenous disease, usually characterized by chronic airway inflammation; defined by history of symptoms such as wheeze, shortness of breath, chest tightness, and cough that vary over time and in intensity

stent

a metal mesh that provides structural support to a coronary vessel, preventing its closure

thrombolytic

a pharmacologic agent that breaks down blood clots; alternatively referred to as a fibrinolytic

desaturate

a precipitous drop in the saturation of hemoglobin with oxygen

high density lipoprotein (HDL)

a protein-bound lipid that transports cholesterol to the liver for excretion in the bile; composed of a higher proportion of protein to lipid than low-density lipoprotein; exerts a beneficial effect on the arterial wall

low density lipoprotein (LDL)

a protein-bound lipid that transports cholesterol to tissues in the body; composed of a lower proportion of protein to lipid than high-density lipoprotein; exerts a harmful effect on the arterial wall

electrocardiogram (ECG)

a record of a test that graphically measures the electrical activity of the heart, including each phase of the cardiac cycle

elective replacement indicator (ERI)

a signal produced by a pacemaker when it is interrogated to indicate a near-depleted battery

postural (orthostatic) hypotension

a significant drop in BP (20 mm Hg systolic or 10 mm Hg diastolic or more) after an upright posture is assumed

hypertonic solution

a solution with an osmolality higher than that of serum

hypotonic solution

a solution with an osmolality lower than that of serum

isotonic solution

a solution with the same osmolality as serum and other body fluids

coronary artery bypass graft (CABG)

a surgical procedure in which a blood vessels from another part of the body is grafted onto the occluded coronary artery below the occlusion in such a way that blood flow bypasses the block

cardiac stress test

a test used to evaluate the functioning of the heart during a period of increased oxygen demand; test may be initiated by exercise or medications

ascites

a type of edema in which fluid accumulates in the peritoneal cavity

percutaneous transluminal coronary angioplasty (PTCA)

a type of percutaneous coronary intervention in which a balloon is inflated within a coronary artery to break an atheroma and open the vessel lumen, improving coronary artery blood flow

automaticity

ability of the cardiac cells to initiate an electrical impulse

contractility

ability of the cardiac muscle to shorten in response to an electrical impulse

pulmonary edema

abnormal accumulation of fluid in the interstitial spaces and alveoli of the lungs

pleural effusion

abnormal accumulation of fluid in the pleural space

atherosclerosis

abnormal accumulation of lipid deposits and fib

opening snaps

abnormal diastolic sound generated during opening of a rigid atrioventricular valve leaflet

summation gallop

abnormal sounds created by the presence of an S3 and S4 during periods of tachycardia

systolic click

abnormal systolic sound created by the opening of a calcified aortic or pulmonic valve during ventricular contraction

sudden cardiac death

abrupt cessation of effective heart activity

empyema

accumulation of purulent material in the pleural space

acute decompensated heart failure

acute exacerbation of heart failure, with signs and symptoms of severe respiratory distress and poor systemic perfusion

The ICU nurse is caring for a client who was admitted with a diagnosis of smoke inhalation. The nurse knows that this client is at increased risk for which of the following?

acute respiratory distress syndrome

A client has a medical diagnosis of an advanced first-degree atrioventricular block and is symptomatic. What initial treatment will the nurse be prepared to complete?

administer an IV bolus of atropine

he nurse is assessing a client with left-sided heart failure. What assessment finding is expected?

air hunger

Which is the strongest predisposing factor for asthma?

allergy

stroke volume

amount of blood ejected from one of the ventricles per heartbeat

cardiac output

amount of blood pumped by each ventricle in liters per minute

S3

an abnormal heart sound detected early in diastole as resistance is met to blood entering either ventricle; most often due to volume overload associated with heart failure

S4

an abnormal heart sound detected late in diastole as resistance is met to blood entering either ventricle during atrial contraction; most often caused by hypertrophy of the ventricle

induration

an abnormally hard lesion or reaction, as in a positive tuberculin skin test

alkalosis

an acid-base imbalance characterized by a reduction in H+ concentration (increased blood pH) (a high arterial pH with increased bicarbonate concentration is called metabolic alkalosis, a high arterial pH due to reduced PCO2 is called respiratory alkalosis)

acidosis

an acid-base imbalance characterized by an increase in H+ concentration (decreased blood pH) (a low arterial pH due to reduced bicarbonate concentration is called metabolic acidosis; a low arterial pH due to increased PCO2 is called respiratory acidosis)

cardiac catheterization

an invasive procedure used to measure cardiac chamber pressures and assess patency of the coronary arteries

acute lung injury

an umbrella term for hypoxemia respiratory failure; acute respiratory distress syndrome is a severe form of acute lung injury

open lung biopsy

biopsy of the lung tissue performed through a limited thoracotomy incision

cardiac resynchronization therapy (CRT)

biventricular pacing used to correct interventricular, intraventricular, and atrioventricular conduction disturbances that occur in patients with heart failure

hypertension

blood pressure that is persistently greater than 140/90mm Hg

central cyanosis

bluish discoloration of the skin or mucous membranes due to hemoglobin carrying reduced amounts of oxygen

Which is not a likely origination point for cardiac dysrhythmias?

bundle of His

The clinic nurse is caring for a client with acute bronchitis. The client asks what may have caused the infection. What may induce acute bronchitis?

chemical irritation

angina pectoris

chest pain brought about by myocardial ischemia

bronchiectasis

chronic, irreversible dilation of the bronchi and bronchioles that results from the destruction of muscles and elastic connective tissue; dilated airways become saccular and are a medium for chronic infection

A nurse is caring for a client after a thoracentesis. Which sign, if noted in the client, should be reported to the physician immediately?

client is becoming agitated and complains of pleuritic pain

atelectasis

collapse or airless condition of the alveoli caused by hypoventilation, obstruction to the airways, or compression

A young adult with cystic fibrosis is admitted to the hospital for an acute airway exacerbation. Aggressive treatment is indicated. What is the first action by the nurse?

collects sputum for culture and sensitivity

pulseless electrical activity (PEA)

condition in which electrical activity is present on an electrocardiogram, but there is not an adequate pulse or blood pressure

myocardial ischemia

condition in which heart muscle cells receive less oxygen than needed

dromotropy

conduction velocity

purulent

consisting of, containing, or discharging pus

Which term refers to lung tissue that has become more solid in nature as a result of a collapse of alveoli or an infectious process?

consolidation

Which medication is contraindicated in acute asthma exacerbations?

cromolyn sodium

myocardial infarction (MI)

death of heart tissue caused by lack of oxygenated blood flow

The nurse is admitting a client with frothy pink sputum. What does the nurse suspect is the primary underlying disorder of pulmonary edema?

decreased left ventricular pumping

preload

degree of stretch of the cardiac muscle fibers at the end of diastole

asbestosis

diffuse lung fibrosis resulting from exposure to asbestos fibers

A nurse is assisting with a subclavian vein central line insertion when the client's oxygen saturation drops rapidly. He complains of shortness of breath and becomes tachypneic. The nurse suspects the client has developed a pneumothorax. Further assessment findings supporting the presence of a pneumothorax include:

diminished or absent breath sounds on the affected side.

oliguria

diminished urine output; less than 0.5 mL/kg/h

restrictive lung disease

disease of the lung that causes a decrease in lung volumes

dysrhythmia

disorder of the formation or conduction (or both) of the electrical impulses within the heart, alerting the heart rate, heart rhythm, or both and potentially causing altered blood flow (also referred to as arrhythmia)

artifact

distorted, irrelevant, and extraneous electrocardiographic (ECG) waveforms

The nurse assessing a client with an exacerbation of heart failure identifies which symptom as a cerebrovascular manifestation of heart failure (HF)?

dizziness

A client has been having cardiac symptoms for several months and is seeing a cardiologist for diagnostics to determine the cause. How will the client's ejection fraction be measured?

echocardiogram

The nurse is caring for a client with atrial fibrillation. What procedure would be recommended if drug therapies did not control the dysrhythmia?

elective cardio version

depolarization

electrical activation of a cell caused by the influx of sodium into the cell while potassium exits the cell

sinus rhythm

electrical activity of the heart initiated by the sinoatrial node

cardioversion

electrical current given in synchrony with the patient's own QRS complex to stop a dysrhythmia

defibrillation

electrical current given to stop a dysrhythmia, not synchronized with the patient's QRS complex

A client with unresolved hemothorax is febrile, with chills and sweating. He has a nonproductive cough and chest pain. His chest tube drainage is turbid. A possible explanation for these findings is:

empyema

Class 1 with regard to TB indicates

exposure and no evidence of infection

The nurse knows the mortality rate is high in lung cancer clients due to which factor?

few early symptoms

atheroma

fibrous cap composed of smooth muscle cells that forms over lipid deposits within arterial vessels and protrudes into the lumen of the vessel, narrowing the lumen and obstructing blood flow; also called plaque

A patient arrives in the emergency department after being involved in a motor vehicle accident. The nurse observes paradoxical chest movement when removing the patient's shirt. What does the nurse know that this finding indicates?

flail chest

tonicity

fluid tension or the effect that osmotic pressure of a solution with impermeable solutes exerts on cell size because of water movement across the cell membrane

inotropy

force of myocardial contraction

alpha1-antitrypsin deficiency

genetic disorder resulting from deficiency of alpha1-antitrypsin, a protective age for the lung; increases patient's risk for developing panacinar emphysema even in the absence of smoking

A client diagnosed with asthma is preparing for discharge. The nurse is educating the client on the proper use of a peak flow meter. The nurse instructs the client to complete which action?

if coughing occurs during the procedure, repeat it.

A nurse is caring for a client with chest trauma. Which nursing diagnosis takes the highest priority

impaired gas exchange

A client with bronchiectasis is admitted to the nursing unit. The primary focus of nursing care for this client includes

implementing measures to clear pulmonary secretions

apical impulse

impulse normally palpated at the fifth intercostal space, left midclavicular line; caused by contraction of the left ventricle; also called the point of maximal impulse

systolic heart failure

inability of the heart to pump sufficiently because of an alteration in the ability of the heart to contract; term used to describe a type of heart failure

left sided heart failure

inability of the left ventricle to fill or eject sufficient blood into the systemic circulation

right sided heart failure

inability of the right ventricle to fill or eject sufficient blood into the pulmonary circulation

air trapping

incomplete emptying of alveoli during expiration due to loss of lung tissue elasticity (emphysema), bronchospasm (asthma), or airway obstruction

Which measure may increase complications for a client with COPD?

increased oxygen supply

In a client with amyotrophic lateral sclerosis (ALS) and respiratory distress, which finding is the earliest sign of reduced oxygenation?

increased restlessness

aspiration

inhalation of either oropharyngeal or gastric contents into the lower airways

thoracentesis

insertion of a needle into the pleural space to remove fluid that has accumulated and decrease pressure on the lung tissue; may also be used diagnostically to identify potential causes of a pleural effusion

fine-needle aspiration

insertion of a needle through the chest wall to obtain cells of a mass or tumor; usually performed under fluoroscopy or chest computed tomography guidance

ischemia

insufficient tissue oxygenation

A client with dilated cardiomyopathy is having frequent episodes of ventricular fibrillation. What medical treatment does the nurse anticipate the client will have to terminate the episode of ventricular fibrillation?

internal cardioverter defibrillator insertion

A client diagnosed with acute respiratory distress syndrome (ARDS) is restless and has a low oxygen saturation level. If the client's condition does not improve and the oxygen saturation level continues to decrease, what procedure will the nurse expect to assist with in order to help the client breathe more easily?

intubate the client and control breathing with mechanical ventilation

pleural friction rub

localized grating or creaking sound caused by the rubbing together of inflamed parietal and visceral pleurae

homeostasis

maintenance of a constant internal equilibrium in a biologic system that involves positive and negative feedback mechanisms

What is histamine, a mediator that supports the inflammatory process in asthma, secreted by?

mast cells

The classification of Stage II of COPD is defined as

moderate COPD

myocardium

muscle layer of the heart responsible for the pumping action of the heart

A client is prescribed digitalis medication. Which condition should the nurse closely monitor when caring for the client?

nausea and vomiting

baroreceptors

nerve fibers located in the aortic arch and carotid arteries that are responsible for control of the blood pressure

acute respiratory distress syndrome (ARDS)

nonspecific pulmonary response to a variety of pulmonary and nonpulmonary insults to the lung; characterized by interstitial infiltrates, alveolar hemorrhage, atelectasis, decreased compliance, and refractory hypoxemia

A client is being seen in the emergency department for exacerbation of chronic obstructive pulmonary disease (COPD). The first action of the nurse is to administer which of the following prescribed treatments?

oxygen through nasal cannula at 2L/minute

A nurse assesses arterial blood gas results for a patient in acute respiratory failure (ARF). Which results are consistent with this disorder?

pH 7.28, PaO2 50 mm Hg

Which is a key characteristic of pleurisy?

pain

hemothorax

partial or complete collapse of the lung due to blood accumulating in the pleural space; may occur after surgery or trauma

pneumothorax

partial or complete collapse of the lung due to positive pressure in the pleural space

pressurized metered dose inhaler

patient-activated medication canister that provides aerosolized medication that the patient inhales into the lungs

ejection fraction (EF)

percentage of blood volume in the ventricles at the end of diastole that is ejected during systole; a measurement of contractility

ejection fraction

percentage of the end- diastolic blood volume ejected from the ventricle with each heartbeat

The nurse is assigned the care of a 30-year-old client diagnosed with cystic fibrosis (CF). Which nursing intervention will be included in the client's care plan?

performing chest physiotherapy as ordered

systole

period of ventricular contraction resulting in ejection of blood from the ventricles into the pulmonary artery and aorta

diastole

period of ventricular relaxation resulting in ventricular filling

active transport

physiologic pump that moves fluid from an area of lower concentration to one of higher concentration; requires adenosine triphosphate for energy

A physician stated to the nurse that the client has fluid in the pleural space and will need a thoracentesis. The nurse expects the physician to document this fluid as

pleural effusion.

tension pneumothorax

pneumothorax characterized by increasing positive pressure in the pleural space with each breath; this is an emergency situation, and the positive pressure needs to be decompressed or released immediately

In COPD, the body attempts to improve oxygen-carrying capacity by increasing the amount of red blood cells. Which term refers to this process?

polycythemia

sinoatrial (SA) node

primary pacemaker of the heart, located in the right atrium

pericardiocentesis

procedure that involves aspiration of fluid from the pericardial sac

repolarization

process by which cardiac muscle cells return to a more negatively charged intracellular condition, their resting state

What does a positive Mantoux test indicate?

production of an immune response

You are caring for a client with chronic respiratory failure. What are the signs and symptoms of chronic respiratory failure?

progressive loss of lung function associated with chronic disease

The nurse is assigned to care for a patient with COPD with hypoxemia and hypercapnia. When planning care for this patient, what does the nurse understand is the main goal of treatment?

providing sufficient oxygen to improve oxygenation

Which diagnostic test is the most accurate in assessing acute airway obstruction?

pulmonary function studies

spirometry

pulmonary function tests that measures specific lung volumes and rates may be measured before and after bronchodilator administration

A 28-year-old client presents to the emergency department, stating severe restlessness and anxiety. Upon assessment, the client's heart rate is 118 bpm and regular, the client's pupils are dilated, and the client appears excitable. Which action should the nurse take next?

question the client about alcohol and illicit drug use

chronotropy

rate of impulse formation

ablation

removal of material, by mechanical means, from the surface of an object; in the context of cardiology, it is the purposeful destruction of heart muscle cells, usually in an attempt to correct or eliminate a dysrhythmia

systemic vascular resistance

resistance to blood flow out of the left ventricle created by the systemic circulatory system

pulmonary vascular resistance

resistance to blood flow out of the right ventricle created by the pulmonary circulatory system

A nurse administers albuterol (Proventil), as ordered, to a client with emphysema. Which finding indicates that the drug is producing a therapeutic effect?

respiratory rate of 22 breaths/minute

repolarization

return of the cell to resting state, caused by reentry of potassium into the cell while sodium exits the cell

atrioventricular (AV) node

secondary pacemaker of the heart, located in the right atrial wall near the tricuspid valve

The classification of Stage III of COPD is defined as

severe COPD

paroxysmal nocturnal dyspnea (PND)

shortness of breath that occurs suddenly during sleep

orthopnea

shortness of breath when lying flat

A client asks a nurse a question about the Mantoux test for tuberculosis. The nurse should base her response on the fact that the:

skin test doesn't differentiate between active and dormant tuberculosis infection

murmors

sounds created by abnormal, turbulent flow of blood in the heart

normal heart sounds

sounds produced when the valves close; normal heart sounds are S1 (AV valves) and S2 (semilunar valves)

cardiac conduction system

specialized heart cells strategically located throughout the heart that responsible for methodically generating and coordinating the transmission of electrical impulses to the myocardial cells

A patient comes to the clinic for the third time in 2 months with chronic bronchitis. What clinical symptoms does the nurse anticipate assessing for this patient?

sputum and a productive cough

pericardiotomy

surgically created opening of the pericardium

pulsus paradoxus

systolic blood pressure that is more than 10 mm Hg lower during inhalation than during exhalation; difference is normally less than 10 mm Hg

The nurse assesses a patient for a possible pulmonary embolism. What frequent sign of pulmonary embolus does the nurse anticipate finding on assessment?

tachypnea

A mediastinal shift occurs in which type of chest disorder?

tension pneumothorax

afterload

the amount of resistance to ejection of blood from the ventricle

hemoptysis

the coughing up of blood from the lower respiratory tract

pulse deficit

the difference between the apical and radial pulse rates

PP interval

the duration between the beginning of one P wave and the beginning of the next P wave; used to calculate atrial rate and rhythm

RR interval

the duration between the beginning of one QRS complex and the beginning of the next QRS complex; used to calculate ventricular rate and rhythm

S1

the first heart sound produced by closure of the atrioventricular (mitral and tricuspid) valves

diastolic heart failure

the inability of the heart to pump sufficiently because of an alteration in the ability of the heart to fill; term used to describe a type of heart failure

osmolality

the number of milliosmoles (standard unit of osmotic pressure) per kilogram of solvent; expressed as milliosmoles per liter; describes the concentration of solutes or dissolved particles

osmolarity

the number of milliosmoles (standard unit of osmotic pressure) per liter of solution; describes the concentration of solutes or dissolved particles

U wave

the part of an ECG that may reflect Purkinje fiber repolarization; usually, it is not seen unless a patient's serum potassium level is low

PR interval

the part of an ECG that reflects conduction of an electrical impulse from the sinoatrial node through the atrioventricular node

P wave

the part of an ECG that reflects conduction of an electrical impulse through the atrium; atrial depolarization

QRS complex

the part of an ECG that reflects conduction of an electrical impulse through the ventricles; ventricular depolarization

T wave

the part of an ECG that reflects repolarization of the ventricles

ST segment

the part of an ECG that reflects the end of the QRS complex to the beginning of the T wave

TP interval

the part of an ECG that reflects the time between the end of the T wave and the beginning of the next P wave; used to identify the isoelectric line

QT interval

the part of an ECG that reflects the time from ventricular depolarization through repolarization

hydrostatic pressure

the pressure created by the weight of fluid against the wall that contains it. In the body, hydrostatic pressure in blood vessels results from the weight of fluid itself and the force resulting from cardiac contraction.

osmosis

the process by which fluid moves across a semipermeable membrane from an area of low solute concentration to an area of high solute concentration; the process continues until the solute concentrations are equal on both sides of the membrane

diffusion

the process by which solutes move from an area of higher concentration to one of lower concentration; does not require expenditure of energy

telemetry

the process of continuous electrocardiographic monitoring by the transmission of radio waves from a battery-operated transmitter worn by the patient

ventilation-perfusion ratio

the ratio between ventilation and perfusion in the lung; matching of ventilation to perfusion optimizes gas exchange

S2

the second heart sound produced by closure of the semilunar (aortic and pulmonic) valves

The client asks the nurse to explain the reason for a chest tube insertion in treating a pneumothorax. Which is the best response by the nurse?

the tube will drain air from the space around the lung

hemodynamic monitoring

the use of pressure monitoring devices to directly measure cardiovascular function

transbronchial

through the bronchial wall, as in a trans bronchial lung biopsy

conduction

transmission of electrical impulses from one cell to another

The nurse is caring for a client with suspected ARDS with a pO2 of 53. The client is placed on oxygen via face mask and the PO2 remains the same. What does the nurse recognize as a key characteristic of ARDS?

unresponsive arterial hypoxemia

radioisotopes

unstable atoms that give off small amounts of energy in the form of gamma rays as the decay; used in cardiac nuclear medicine studies

anuria

urine output of less than 50mL/24 h

A nurse is caring for a client admitted with an exacerbation of asthma. The nurse knows the client's condition is worsening when he:

uses the sternocleidomastoid muscles.

The classification of Stage IV of COPD is defined as

very severe COPD

A client at risk for pneumonia has been ordered an influenza vaccine. Which statement from the nurse best explains the rationale for this vaccine?

viruses like influenza are the most common cause of pneumonia

A patient with hypertension has a newly diagnosed atrial fibrillation. What medication does the nurse anticipate administering to prevent the complication of atrial thrombi?

warfarin