Patho Exam 3

Cardiac tamponade and pericardial effusion can be life-threatening when the pericardial sac _______ and ______ the heart. thickens; stretches fills rapidly; compresses ruptures; releases contracts; friction rubs

fills rapidly; compresses

A monitored hospitalized client with a pulmonary embolism has been in atrial fibrillation (AF) for 4 days. The nurse observes the rhythm spontaneously convert to a normal sinus rhythm. Which form of AF is this? Chronic Persistent Paroxysmal Permanent

Paroxysmal

Which client will the nurse prioritize to assess first? client with sinus arrest client with tachycardia client with sinus bradycardia client with respiratory sinus arrhythmia

client with sinus arrest

The pathophysiology of heart failure involves an interaction between decreased pumping ability and the ________ to maintain cardiac output. compensatory mechanisms parasympathetic system electrical conductivity aortic hypertrophy

compensatory mechanisms

A client calls the health care provider's office and frantically tells the nurse his TB test is red, and he is afraid this means he has tuberculosis. The best response by the nurse would be: "This result definitely confirms the diagnosis; we will begin treatment now." "Wait until tomorrow to see if things change." "Have you eaten anything unusual to cause this reaction?" "A definitive diagnosis of active pulmonary tuberculosis requires cultures or DNA amplification techniques."

"A definitive diagnosis of active pulmonary tuberculosis requires cultures or DNA amplification techniques."

A nurse is caring for a client with an average heart rate of 56 beats/min. The client has no adverse symptoms associated with this heart rate and is receiving no treatment. Which activity modification should the nurse suggest to avoid further slowing of the heart rate? "Limit your intake of caffeinated drinks." "Avoid bearing down while having a bowel movement." "Avoid strenuous aerobic exercise." "Avoid stress or overexcitement."

"Avoid bearing down while having a bowel movement."

A client in the nursing home wonders why he is having these signs and symptoms of left-sided heart failure. Which explanation will the nurse give the client? "The left ventricle is having problems pumping blood forward, and this is causing blood to back up into your lungs." "The left ventricle is pumping excessive amounts of blood through the carotid arteries causing headache." "The left ventricle is not adequately perfusing your gastrointestinal tract, leading to diarrhea and vomiting." "The left ventricle is having problems pumping blood forward, so blood is backing up systemically causing edema in your feet."

"The left ventricle is having problems pumping blood forward, and this is causing blood to back up into your lungs."

Oxygen has been prescribed for a client with chronic obstructive pulmonary disease (COPD). Which amount of oxygen is considered most appropriate for the COPD client? 1 to 2 L/min 5 L/min 4 to 6 L/min 10 L/min

1 to 2 L/min

The nurse knows that the main objective of the management of hypertension is to achieve a sustainable level of blood pressure below: a. 140/60 b. 100/60 c. 100/90 d. 140/90

140/90

The nurse is monitoring hourly urine output of a client diagnosed with hypovolemic shock. The nurse is most concerned if the client's output is: 60 mL/hour 20 mL/hour 80 mL/hour 40 mL/hour

20 mL/hour

Which client most likely faces the highest risk of developing secondary pulmonary hypertension? A client with asthma who uses her inhaled bronchodilator more often than prescribed A client who suffered a thermal injury to his lungs in a fire An older adult client who has been hospitalized for the treatment of community-acquired pneumonia A client with COPD and a 35 pack-year smoking history.

A client with COPD and a 35 pack-year smoking history.

A client sustained a puncture injury to the chest resulting in development of a tension pneumothorax. What is the pathogenesis behind a tension pneumothorax? The opposite lung hyperinflates to compensate for the collapsed lung. Expired air exits the bleeding wound at a faster rate than inhalation. Air is permitted to enter but not leave the pleural space, causing lung collapse. Blebs on the lung surface rupture due to increased intrapleural pressure.

Air is permitted to enter but not leave the pleural space, causing lung collapse.

Prolonged immobility is implicated in the development of which disorder? Bronchitis and bronchiectasis Pulmonary hypertension and cor pulmonale Sarcoidosis and idiopathic pulmonary fibrosis Atelectasis and pulmonary embolism

Atelectasis and pulmonary embolism

Following several weeks of increasing fatigue and a subsequent diagnostic workup, a client has been diagnosed with mitral valve regurgitation. Failure of this heart valve would have which hemodynamic consequences? Backup of blood from the right atrium into the superior vena cava Inhibition of the SA node's normal action potential Backflow from the right ventricle to the right atrium during systole Backflow from the left ventricle to left atrium

Backflow from the left ventricle to left atrium

A middle-aged client with a 30-year history of smoking was diagnosed with lung cancer. A health history revealed previous exposure to air pollution, asbestos, and radiation. Which factor most likely had the greatest impact on development of the lung cancer? Cigarette smoke Air pollution Radiation Asbestos

Cigarette smoke

A client with primary lung disease has developed right heart failure. The health care provider would document this as: Cor pulmonale Adult respiratory distress syndrome Primary hypertension Cardiac tamponade

Cor pulmonale The term cor pulmonale refers to right-sided heart failure resulting from primary lung disease or pulmonary hypertension. The increased pressures and work result in hypertrophy and eventual failure of the right ventricle. The manifestations of cor pulmonale include the signs and symptoms of the primary lung disease and the signs of right-sided heart failure. Primary hypertension is elevated blood pressure of unknown cause. Cardiac tamponade is pressure on the heart that occurs when blood or fluid builds up in the space.

What intervention is appropriate for a client with sarcoidosis? Antifungal agents Antihistamines Lymph node radiation Corticosteroids

Corticosteroids

A client is immobilized following a hip injury. The client has developed lower leg discoloration with edema, pain, and tenderness in the midcalf area. How should the nurse document these clinical findings? Stasis ulcerations Deep vein thrombosis Arterial insufficiency Primary varicose veins

Deep vein thrombosis

A client's electrocardiogram monitor begins to sound an alarm and shows sustained ventricular fibrillation. The client is unconscious and without a pulse. Which priority intervention should the nurse take? Administer IV push atropine Defibrillate the client Notify the client's attending physician Perform synchronized cardioversion

Defibrillate the client

The nursing student correctly identifies which major risk factors for coronary artery disease? Select all that apply. Decreased pulse rate Elevated blood pressure Diabetes Cigarette smoking Elevated LDL Elevated HDL Abdominal obesity

Elevated blood pressure Diabetes Cigarette smoking Elevated LDL Abdominal obesity

The nurse is reviewing laboratory results for a client who is experiencing angina. Which finding might be expected in a client with dyslipidemia? Elevated total cholesterol Decreased triglycerides Decreased low-density lipoproteins Normal cholesterol and triglycerides

Elevated total cholesterol

Which conditions increase client risk for developing pulmonary arterial hypertension (PAH)? Select all that apply. HIV infection Diabetes mellitus Breast cancer Family history Scleroderma

HIV infection Family history Scleroderma

Nearly everyone with pericarditis has chest pain. With acute pericarditis, the pain is abrupt in onset, sharp, and radiates to the neck, back, abdomen, or sides. What can be done to ease the pain of acute pericarditis? Have the client swallow slowly and frequently. Have the client change positions to unaffected side. Have the client breathe deeply. Have the client sit up and lean forward.

Have the client sit up and lean forward.

The health care provider is discussing major risk factors for coronary artery disease (CAD) with a client. The most important information for the provider to include would be: Advanced age and low serum total and low-density lipoprotein cholesterol History of cigarette smoking and elevated blood pressure High serum high-density lipoprotein and diabetes Physical inactivity and high serum high-density lipoprotein cholesterol

History of cigarette smoking and elevated blood pressure

A young college football player was bought to the emergency room after collapsing on the football field during practice. When arriving he was unconscious and his ECG was abnormal. Subsequently he died after arresting in the emergency room. What does the physician suspect is the likely cause of this? Pericarditis Dehydration Hypertrophic cardiomyopathy Heart attack

Hypertrophic cardiomyopathy

Increased cardiac workload with left-sided heart failure can result in which change to the myocardial cells? Hyperplasia Hypertrophy Dysplasia Atrophy

Hypertrophy

A client with a history of emphysema is experiencing hypoxemia after a taxing physical therapy appointment. Which physiologic phenomenon will occur as a consequence of hypoxemia? Hypoventilation Increased heart rate Necrosis Peripheral vasodilation

Increased heart rate

A child has developed respiratory stridor and is displaying a crowing sound. The parents ask the nurse what is causing this sound. The best response would be: Increased turbulence of air moving through the obstructed airways Pulling in of the soft tissue surrounding the cartilaginous and bony thorax Nasal obstruction and inhalation occurring through the mouth rather than the nares The collapse of intrathoracic airways because of air trapping

Increased turbulence of air moving through the obstructed airways

An 86-year-old client is disappointed to learn that he or she has class II heart failure despite a lifelong commitment to exercise and healthy eating. Which age-related change predisposes older adults to the development of heart failure? Increased vascular stiffness Orthostatic hypotension Increased cardiac contractility Loss of action potential

Increased vascular stiffness

A client asks the nurse if it is possible to contract influenza by being exposed to wound secretions. On what knowledge should the nurse base her response to the client? Influenza transmission occurs through contact with the skin of an infected person. Influenza transmission occurs by inhalation of droplet nuclei. Influenza is transmitted by exposure to urine, blood, and body secretions. Influenza may be contracted by touching a surface that an infected person has touched.

Influenza transmission occurs by inhalation of droplet nuclei.

Respiratory sinus dysrhythmia is considered a more optimal rhythm than a rhythm where all RR intervals are equal. In respiratory sinus dysrhythmia, what is the variation in cardiac cycles related to? Intra-abdominal pressure changes that occur with respiration Intrathoracic pressure changes that occur with respiration Intra-abdominal pressure changes due to vagal nerve stimulus Intrathoracic pressure changes due to inadequate oxygenation

Intrathoracic pressure changes that occur with respiration

The nurse's brother is not convinced that he should quit smoking. He asks his sister (the nurse) to demonstrate for him the more immediate effects of smoking on his health. Which of the following could be used to help convince the brother to stop smoking? Have him listen to his heart for the obvious murmur that presents when smoking. Measure his pulse and show him how much lower it is when he is smoking. Measure his temperature and show him how much higher it is when he is smoking. Measure his blood pressure and show him how much higher it is when he is smoking.

Measure his blood pressure and show him how much higher it is when he is smoking.

Which problem in neonates can result in increased upper airway resistance and decreased airflow into the lungs? Nasal congestion Productive coughing Frequent crying Sleeping supine

Nasal congestion

A client hospitalized for 72 hours has developed symptoms of a lower respiratory tract infection. Sputum cultures reveal S. aureus as the infectious organism. The nurse explains to the client that the most likely cause of this infection is: Opportunistic infection Community-acquired infection Autoimmune disease Nosocomial hospital-acquired infection (HAI)

Nosocomial hospital-acquired infection (HAI)

The older adult client tells the health care provider about experiencing dizziness when changing from a lying to a sitting position. The provider will document which condition in the medical record? Orthostatic hypotension Increased responsiveness to catecholamines Systolic hypertension Decrease in peripheral vascular resistance

Orthostatic hypotension

A client comes to the emergency room exhibiting signs and symptoms of right-sided heart failure. Upon X-ray it is determined that he has 250 mL of fluid in the pericardial cavity. Which disease should the nurse suspect this client is suffering? Myocardial infarction COPD Pericardial effusion Pericarditis

Pericardial effusion

While lecturing on blood pressure, the nurse will emphasize that the body maintains its blood pressure by adjusting the cardiac output to compensate for changes in which physiologic process? Peripheral vascular resistance Release of stress hormones Rigidity of the ventricular walls Electrical impulses in the heart

Peripheral vascular resistance

A newly admitted critical head injury client presents to the neuro-ICU. The client is unresponsive to painful stimuli but able to breathe on his own. As the shift progresses, the nurses note a decrease in the client's respiratory effort. The client cannot maintain his O2 saturation above 70%. The nurses should anticipate assisting in beginning what type of pulmonary support? Begin Bi-PAP. Increase oxygen level to 10 L/min. Prepare for mechanical ventilation. Call respiratory therapy to suction the client.

Prepare for mechanical ventilation

A client is at high risk for the development of rheumatic heart disease. The most important information for the nurse to provide would be: Yearly electrocardiography after the age of 50 Annual blood specimen assessed for rheumatoid factor Avoiding frequent dental examinations Prompt diagnosis and treatment of streptococcal infections

Prompt diagnosis and treatment of streptococcal infections

A 3-year-old child has been admitted to the pediatric unit for the treatment of croup. The nurse should include which action in the child's plan of care? Providing cool, moist air for the child to breathe Providing a low-stimulation environment to relieve bronchospasm Administering antiviral medications such as zanamivir and oseltamivir as ordered Establishing IV access and administering sulfa antibiotics as ordered

Providing cool, moist air for the child to breathe

A client with newly diagnosed squamous cell carcinoma of the lung asks, "So how do we treat this cancer?" Which response from the health care provider is most accurate? Select all that apply. Radiation therapy Monoclonal antibody Surgery to remove tumor Chemotherapy Stem cell transplant

Radiation therapy Surgery to remove tumor Chemotherapy

A female client tells the health care provider that she has recently been experiencing episodes of changes occurring in the color of her fingertips, especially when she experiences cold temperatures. She further states that the tips become pale, turn a bluish color, and then become reddened. The client is most likely experiencing: Vasculitis Atherosclerosis Thromboangiitis obliterans Raynaud phenomenon

Raynaud phenomenon

What is the correct sequence for the generation of electrical impulses in the heart causing ventricular contraction? SA node - AV node - bundle of His - bundle branches - Purkinje fibers AV node - SA node - bundle of His - bundle branches - Purkinje fibers AV node - bundle of HIS - bundle branches - SA node - Purkinje fibers SA node - AV node - bundle branches - Purkinje fibers - bundle of His

SA node - AV node - bundle of His - bundle branches - Purkinje fibers

A child struggling to breathe is brought to the emergency department with a prolonged bronchospasm and severe hypoxemia. Assessment revealed the use of accessory muscles, a weak cough, audible wheezing sound, moist skin, and tachycardia. What is the most likely diagnosis? Cystic fibrosis Pulmonary embolism Severe asthma attack Chronic obstructive pulmonary disease

Severe asthma attack

A 28-year-old marathon runner comes to the clinic to obtain a physical exam for a new job. The nurse assesses a regular pulse rate of 52 beats per minute (bpm). Which common dysrhythmia is the nurse aware this client most likely has related to maintaining a large stroke volume? Atrial fibrillation Sinus tachycardia Atrial flutter Sinus bradycardia

Sinus brachycardia

Which characteristic of the lungs of infants and small children creates an increased risk of respiratory disorders? The pneumotaxic center in the pons is underdeveloped until 8 years of age. Smaller airways create a susceptibility to changes in airway resistance and airflow. Type II alveoli in children may overproduce surfactant. There are fewer chemoreceptors in the young medulla.

Smaller airways create a susceptibility to changes in airway resistance and airflow.

A client has developed bacterial pneumonia and is admitted to the hospital. The nurse obtains sputum cultures upon admission. What bacteria does the nurse anticipate finding when the results are complete? Staphylococcus aureus Pseudomonas aeruginosa Streptococcus pneumoniae Escherichia coli

Streptococcus pneumoniae

A 60-year-old woman who has lost an extensive amount of blood in a work-related accident says that when her blood pressure was checked in the hospital, the top number (systolic pressure) was lower than usual but the bottom number (diastolic pressure) was about the same. The nurse recognizes that which reason accounts for this lack of change in the diastolic pressure? Systemic vasoconstriction maintained the diastolic pressure. Stroke volume increased with blood loss. Blood volume rapidly increased. Heart rate increased with blood loss.

Systemic vasoconstriction maintained the diastolic pressure.

A client has been diagnosed with a dissecting aortic aneurysm. It is most important for the nurse to assess the client for: Late hypertensive crisis Chest pain radiating to the right arm Tonic-clonic seizures Tearing or ripping-type pain in the chest or back

Tearing or ripping-type pain in the chest or back

The postoperative client has a catheter in his brachial artery for continuous blood pressure monitoring. Which assessment would be a concern for the nurse? Pulses are present in the radial artery. The nail beds are pink. The client states his hand is numb. The client states his feet are cold.

The client states his hand is numb.

The nurse knows that the primary long-term regulation of blood pressure is exerted by which body system? Humoral influence Neural mechanisms The kidneys Hormonal activity

The kidneys

Which type of pacing involves the placement of large patch electrodes on the anterior and posterior chest wall that can be connected by a cable to an external pulse generator? Permanent Transcutaneous Transvenous Epicardial

Transcutaneous

A client comes to the emergency room with all the symptoms of a myocardial infarction. Which lab value, known to have a high specificity for myocardial tissue considered the primary biomarker test for diagnosing an MI, does the nurse suspect the physician will order? Troponin assays Creatine kinase Phosphorous Potassium

Troponin assays

A client diagnosed with tuberculosis asks the nurse how long the antitubercular medication will need to be taken. What is the best response? "Drug therapy will continue until all symptoms of tuberculosis have stopped." "You can take drug therapy for as long as 24 months or until all tubercle bacilli are eliminated." "Drug therapy will continue unless a drug resistance develops." "You will be on multiple drug therapy for the rest of your life."

You can take drug therapy for as long as 24 months or until all tubercle bacilli are eliminated."

An older adult client is prescribed a vasodilator for hypertension. Which adverse effect is of greatest concern for an older adult taking this class of drug? a. Constipation b. Hypotension c. Restlessness d. Dry mouth

b. Hypotension

The health care team is developing a plan of care for a client diagnosed with congestive heart failure (CHF). The primary treatment goal would be: maintaining higher oxygen levels to decrease the work of breathing. placing a stent for fluid drainage from the heart. eliminating CHF through curing the disease. improving quality of life by relieving symptoms.

improving quality of life by relieving symptoms.

A client is brought to the emergency department and immediately diagnosed with a tension pneumothorax. The priority intervention would be: administration of oxygen by face mask. chest x-ray. arterial blood gas analysis. insertion of a large-bore needle or chest tube.

insertion of a large-bore needle or chest tube.

A client reports severe indigestion that has been intermittent; however, the pain is now constant and feels like a vise. The nurse does an ECG and recognizes that the situation is possibly emergent due to ST-segment elevation, which could indicate: benign late repolarization. decreased intracranial pressure. advanced hypokalemia. myocardial infarction.

myocardial infarction.

How will the nurse describe unilateral chest pain associated with respiratory movements? musculoskeletal pleuritic bronchitic myocardial

pleuritic

Three days following surgical repair of a hip fracture a client becomes anxious and reports sudden shortness of breath and chest pain that worsens with a deep breath. Which disorder is the client likely experiencing? atelectasis bronchiectasis pneumonia pulmonary embolism

pulmonary embolism

An adult client with a history of worsening respiratory symptoms has presented for care. Which assessment question will best allow the clinician to address the possibility of chronic bronchitis? "Do you have a family history of lung disease?" "Do you know if you had respiratory syncytial virus as a child?" "Do you tend to have a cough even when you don't feel sick?" "Have you ever been immunized against pneumococcal pneumonia?"

"Do you tend to have a cough even when you don't feel sick?" A clinical diagnosis of chronic bronchitis requires the history of a chronic productive cough for at least 3 consecutive months over 2 consecutive years.This is not noted to be a strong genetic component of the disease, and childhood RSV is not a risk factor. Immunization status is normally linked to the development of bronchitis

A child is brought to the emergency department with an asthma attack. Assessment revealed the use of accessory muscles, a weak cough, audible wheezing sound, moist skin, and tachycardia. Which drug will the nurse anticipate administering first? Short-acting beta 2-adrenergic agonists such as albuterol (SABA) Oral corticosteroids Anti-inflammatory agents such as sodium cromolyn Anticholinergic medications such as ipratropium

Short-acting beta 2-adrenergic agonists such as albuterol (SABA)

Which type of blood vessel cells in the tunica media layer produce vasoconstriction and/or dilation of blood vessels? a. Collagen tissue b. Extracellular matrix cells c. Vascular smooth muscle cells (SMCs) d. Endothelial cells

c. Vascular smooth muscle cells (SMCs)

The nurse working in the health department recognizes which clients in her group meet the criteria for beginning antimycobacterial therapy for tuberculosis? Select all that apply. A client who has had a positive skin test A client who has had contact with a family member with active tuberculosis A client who is HIV positive and has not been exposed to the infection A client with active tuberculosis A client with a productive cough

A client who has had contact with a family member with active tuberculosis A client who is HIV positive and has not been exposed to the infection A client with active tuberculosis

Diagnostic testing has resulted in a diagnosis of small cell lung cancer (SCLC) in an older adult client. When exploring the etiology of the client's disease, what assessment question is most relevant? "Have you ever been a smoker?" "Is there any history of cancer among your grandparents, parents, or siblings?" "Do you have chronic obstructive pulmonary disease?" "Have you ever been exposed to radiation during your working life?"

"Have you ever been a smoker?" Most cases of SCLC are attributable to smoking, and it is rare among nonsmokers. Family history and radiation exposure are relevant risk factors, but smoking exceeds their importance. Smoking also causes COPD, but COPD is not an independent risk factor for smoking.

A client who will be undergoing a Holter monitor examination would be given which instruction? "Keep a diary of your activities and symptoms throughout the examination." "Wear clothing that you can exercise in during the test." "You will need to have an intravenous injection prior to the start of the test." "Lay very still during the procedure for an accurate reading."

"Keep a diary of your activities and symptoms throughout the examination."

A client has a myocardial infarction (MI) that has damaged the right atrium, which results in interference with the SA node. The compensatory mechanism, the AV node, becomes the pacemaker of the heart and beats how many times per minute? 10 to 20 beats/minute 65 to 70 beats/minute 21 to 30 beats/minute 45 to 50 beats/minute

45 to 50 beats/minute

The nurse is caring for four clients. Select the client at risk for the development of a pulmonary embolism. A 32-year-old male with viral pneumonia An 80-year-old female client with diabetes A 62-year-old male who is postoperative for repair of a fractured femur A 36-year-old female smoker with an intrauterine device (IUD)

A 62-year-old male who is postoperative for repair of a fractured femur A client with surgery to the lower extremities is at higher risk for the development of deep vein thrombosis that could lead to a pulmonary embolism. There is increased risk for pulmonary embolism among users of oral contraceptives, particularly in women who smoke, but not with the use of IUD.

The practitioner is reviewing the medication list of a client with Raynaud disease. Which medication would the practitioner expect the client to be receiving? A calcium channel-blocker An anticoagulant An antiviral agent A nonsteroidal anti-inflammatory agent

A calcium channel-blocker

The client tells the provider he has lower back pain. Although most abdominal aneurysms are asymptomatic, the provider examines the client for which initial sign of this condition? Hemiplegia Syncope The pulse is unobtainable in one or both arms A pulsating mass in the abdomen

A pulsating mass in the abdomen

A client recovered from influenza 2 days ago and informs the nurse that she is feeling better but now has a fever, chills, pain when breathing, and a productive cough. What complication does the nurse anticipate the client will be treated for? A secondary bacterial pneumonia Reye syndrome Tuberculosis A relapse of the flu

A secondary bacterial pneumonia

A client is transported to the emergency department in respiratory distress after eating peanuts. The following interventions are prescribed by the health care provider. Which intervention should the nurse complete first? Administer diphenhydramine. Start a normal saline infusion. Administer epinephrine (adrenaline). Complete a 12-lead electrocardiogram (ECG).

Administer epinephrine (adrenaline).

Acute-onset bronchial asthma causes wheezing and breathlessness as a result of which of the following? Alveolar collapse Airway inflammation Compression atelectasis Pulmonary hypertension

Airway inflammation Explanation: Bronchial asthma represents a reversible form of obstructive airway disease caused by narrowing of airways due to bronchospasms, inflammation, and increased airway secretions; this inflammatory process produces recurrent episodes of airway obstruction, characterized by wheezing, breathlessness, chest tightness, and cough. Vascular flow through the lungs is unaffected by the airway inflammation and bronchospasms. Hyperinflated alveoli are characteristic of the emphysema type of obstructive pulmonary disease. Compression atelectasis is associated with high external pressure that blocks lung expansion.

Which client would the nurse recognize as needing to be assessed for orthostatic hypotension? A 42-year-old client who has a history of poorly controlled type 1 diabetes An 80-year-old client who has experienced two falls while attempting to ambulate to the bathroom A 65-year-old client whose vision has become much less acute in recent months and who has noticed swelling in the ankles A 78-year-old client who has begun reporting frequent headaches unrelieved by over-the-counter analgesics

An 80-year-old client who has experienced two falls while attempting to ambulate to the bathroom

An infant who was born prematurely and developed respiratory distress syndrome was placed on mechanical ventilation for several weeks. What condition should the nurse monitor the infant for related to the long-term ventilatory support? Spasmodic croup Blastomycosis Bacterial tracheitis Bronchopulmonary dysplasia

Bronchopulmonary dysplasia Explanation: Bronchopulmonary dysplasia (BPD) is a chronic lung disease that develops in premature infants who were treated with long-term mechanical ventilation. High-inspired oxygen concentration and injury from positive-pressure ventilation have been implicated. BPD is characterized by chronic respiratory distress, persistent hypoxemia when breathing room air, reduced lung compliance, increased airway resistance, and severe expiratory flow limitation. The infant with BPD often demonstrates a barrel chest, tachycardia, rapid and shallow breathing, chest retractions, cough, and poor weight gain. p801

A client has developed chronic hypoxia and has developed pulmonary hypertension (HTN). The nurse recognizes that the most likely cause of pulmonary hypertension would be: Constant dilation of the pulmonary vessels in response to hypoxia Hardening of the pulmonary vessels due to increased fat deposits Constriction of the pulmonary vessels in response to hypoxemia Decreased vascular resistance in the pulmonary vessels

Constriction of the pulmonary vessels in response to hypoxemia Pulmonary HTN occurs as a result of chronic hypoxia. In response to hypoxia, the pulmonary vessels constrict. The pulmonary vessels differ from the systemic circulation vessels, which dilate in response to hypoxia and hypercapnia. Smooth muscle hypertrophy and proliferation of the vessel intima occur in pulmonary HTN.

The nurse is caring for a client with a tachydysrhythmia. What assessment finding does the nurse expect? Flushed skin Elevation in blood pressure Decreased cardiac output Bounding pulses

Decreased cardiac output Tachydysrhythmias reduce the diastolic filling time, causing a subsequent decrease in the stroke volume output and in coronary perfusion and increases myocardial oxygen needs. Decreased cardiac output would present with a decreased blood pressure, pale skin, and faint pulses. p. 852.

Which vascular changes can occur in older adults because of the increase in blood pressure during the aging process? Increased elasticity in arterial connective tissue Decreased elasticity in venous connective tissue Increased elasticity in venous connective tissue Decreased elasticity in arterial connective tissue

Decreased elasticity in arterial connective tissue In aging adults, there is a decrease in the elasticity of the aorta and large arteries making them more rigid, thereby increasing systolic blood pressure. This can lead to increased cardiac afterload and hypertension.

An expectant mother is 23 weeks into her pregnancy when she goes into labor. Regarding fetal lung development, what is of greatest concern to the attending medical team? Development of respiratory musculature Development of type II alveolar cells Development of bronchial tree Saccular development of alveoli

Development of type II alveolar cells Type II alveolar cells begin to develop at approximately 24 weeks and produce surfactant, a substance capable of lowering the surface tension of the air-alveoli interface. By 28 to 30 weeks, sufficient amounts of surfactant are available to prevent alveolar collapse when breathing begins. The respiratory musculature, alveoli, and bronchial tree are all developed by the 23rd week.

Atherosclerosis begins in an insidious manner with symptoms becoming apparent as long as 20 to 40 years after the onset of the disease. Although an exact etiology of the disease has not been identified, epidemiologic studies have shown that there are predisposing risk factors to this disease. What is the major risk factor for developing atherosclerosis? Male sex Familial history of premature coronary heart disease Increasing age Hypercholesterolemia

Hypercholesterolemia

The nurse is assisting a client who had a myocardial infarction 2 days ago during a bath. The client suddenly lost consciousness and the nurse was unable to feel a pulse. Cardiopulmonary resuscitation was begun and the client was connected to the monitor with a gross disorganization without identifiable waveforms or intervals observed. What is a priority intervention at this time? Administration of atropine Synchronized cardioversion Immediate defibrillation Applying a transcutaneous pacemaker

Immediate defibrillation

Nursing students who are studying for their upcoming cardiac exam are discussing how the heart could possibly continue to beat once removed from the body. One of the students explains that this phenomenon is directly related to automaticity. What is automaticity? Inherent discharge rate of 40-60 Inherent spontaneous action-potential Inherent low-impulse conductivity Inherent discharge rate of 60-80

Inherent spontaneous action-potential

A client is scheduled to have a Holter monitor for 48 hours to detect disturbances in conduction. Which action is important for the nurse to tell the client to ensure accuracy in correlating dysrhythmias with symptoms? The client must limit activity while the Holter monitor is in place. If the monitor detects a lethal dysrhythmia, it will defibrillate to correct the dysrhythmia. The client may feel a pins and needles sensation while the monitor is connected. It is important to keep a diary of activities and symptoms.

It is important to keep a diary of activities and symptoms.

Anaphylactic shock is the most severe form of systemic allergic reaction. Immunologically medicated substances are released into the blood, causing vasodilation and an increase in capillary permeability. What physiologic response often follows the vascular response in anaphylaxis? Bronchodilation Laryngeal edema Uterine smooth muscle relaxation Gastrointestinal relaxation

Laryngeal edema

A nurse is planning a community education program on lifestyle modification to manage hypertension. Which topic should be included in the teaching plan? Select all that apply. Limit alcohol consumption. Avoid aerobic physical activity. Reduce dietary sodium intake. Stop smoking. Consume a diet rich in fruits, vegetables, and low-fat dairy products.

Limit alcohol consumption. Reduce dietary sodium intake. Stop smoking. Consume a diet rich in fruits, vegetables, and low-fat dairy products.

A 30-year-old client arrives with these vital signs: Blood pressure 50/30 mm Hg, pulse 100 beats/min, respiratory rate 12 breaths/min, temperature 101°F (38.3°C). The nurse interprets these results as the client being in shock based on which reading? Slow respiratory rate Elevated pulse rate Elevated temperature Low blood pressure

Low blood pressure

Which description sums up the basic pathophysiology of heart failure that the nurse would include when educating a client? Low cardiac output due to reduced pumping ability Myocardial remodeling of scar tissue Activated sympathetic (adrenergic) reflexes Reduced tissue perfusion, especially to the kidney

Low cardiac output due to reduced pumping ability

Manifestations of heart failure are due to the decreased pumping ability of the heart. The nurse should monitor for which signs and symptoms of heart failure? Select all that apply. Malnutrition Hyperglycemia Fatigue Cyanosis Exercise intolerance

Malnutrition Fatigue Cyanosis Exercise intolerance

The nurse working in the emergency room triages a client who comes in reporting chest pain, shortness of breath, sweating and elevated anxiety. The physician suspects a myocardial infarction. The client is given a nitrate, which does nothing for his pain. Which medication should the nurse suspect the doctor will order next for the pain? Fentanyl Morphine Demerol Codeine

Morphine

ECG monitoring has been found to be more sensitive than a client's report of symptoms when identifying transient ongoing myocardial ischemia. Why is this? ECG monitoring is reliable only when the client remains still. Most ECG-detected ischemic events cause a great deal of pain. Most ECG-detected ischemic events are clinically silent. The ECG can look at ischemic events from different directions.

Most ECG-detected ischemic events are clinically silent.

The nurse is developing a community program since a recent increase in admissions to the acute care facility with tuberculosis infection. What is the most frequent form of tuberculosis that the nurse should focus on? Ghon tuberculosis Mycobacterium avium-intracellulare complex Pneumocystis jirovecii tuberculosis Mycobacterium tuberculosis

Mycobacterium tuberculosis

Considering the PQRST complex of an electrocardiogram (ECG), which letter designation represents atrial depolarization? P wave ST segment QRS complex T wave

P wave

The nurse assesses the electrocardiogram for depolarization of the atria. What portion of the ECG will the nurse be assessing? U wave above the baseline P wave above the baseline T wave above the baseline Q wave below the baseline

P wave above the baseline

A client is seen in the emergency room reporting sharp chest pain that started abruptly. He says it has radiated to his neck and abdomen. He also states that it is worse when he takes a deep breath or swallows. He tells the nurse that when he sits up and leans forward the pain is better. Upon examination the nurse notes a pericardial friction rub and some EKG changes. Which disease should the nurse suspect this client to have? Pericarditis Abdominal aortic aneurysm Pneumonia Myocardial infarction

Pericarditis

Pain is an expected assessment finding in clients who have which lung disease? Pulmonary arterial hypertension (PAH) Pleural effusion Pleuritis Asthma

Pleuritis

A client experiencing a sinus arrest would demonstrate which symptom or finding? P-wave that occurs more frequently than expected Heart rate of greater than 100 beats/min Prolonged periods of asystole demonstrated on an electrocardiogram Spontaneous persistent sinus bradycardia

Prolonged periods of asystole demonstrated on an electrocardiogram Explanation: Sinus arrest refers to failure of the sinoatrial node to discharge and results in an irregular pulse, prolonged periods of asystole, and predisposition to other dysrhythmias. The other options do not demonstrate the symptoms demonstrated during a sinus arrest.

The nurse knows that vasopressin (antidiuretic hormone, ADH) plays which role in blood pressure control? Promotes retention of water Produces prolonged increase in blood pressure Decreases blood volume Increases osmolality of body fluids

Promotes retention of water

A client has been diagnosed with deep vein thrombosis (DVT). The nurse is planning care and recognizes that the client is most at risk for: Polyarteritis nodosa Vasculitis Pulmonary embolism Arterial insufficiency

Pulmonary embolism

Pulmonary hypertension is usually caused by long-term exposure to hypoxemia. When pulmonary vessels are exposed to hypoxemia, what is their response? Pulmonary vessels infarct Pulmonary vessels spasm Pulmonary vessels constrict Pulmonary vessels dilate

Pulmonary vessels constrict Continued exposure of the pulmonary vessels to hypoxemia is a common cause of pulmonary hypertension. Unlike blood vessels in the systemic circulation, most of which dilate in response to hypoxemia and hypercapnia, the pulmonary vessels constrict.

Following angioplasty for a blocked coronary artery following a myocardial infarction, a client is prescribed serial 12-lead ECGs for three days. On the second day, the nurse notices a distinct difference in the QRS morphology from the previous ECG. Which is the best action for the nurse to take? Repeat ECG with proper lead placement. Repeat the ECG more slowly. Call the physician immediately. File the ECG in the chart.

Repeat ECG with proper lead placement.

The neonatologist explains to the parents of a neonate born at 35 weeks' gestation that their premature infant will be monitored for complications. Which respiratory complication is the most common? Respiratory distress syndrome Intraventricular hemorrhage Periodic breathing Asthma

Respiratory distress syndrome

A client is seen in the emergency department complaining of chest discomfort, productive cough, and a fever of over 101°F (38.3°C) for 3 days. The nurse performs an electrocardiogram and observes a rate of 110 beats per minute (bpm) with a normal P wave and a PR interval of 0.12 second preceding each QRS complex. What does the nurse determine the rhythm to be? Sick sinus syndrome Sinus tachycardia Atrial flutter Third-degree heart block

Sinus tachycardia

Which type of bronchogenic carcinoma has the greatest association with tobacco smoking and tends to metastasize to the brain? Large cell Squamous cell Small cell Adenocarcinoma

Small cell

When talking to a group of homeless women living in a shelter, the nurse should educate about risk for developing tuberculosis. The nurse should emphasize which lab/diagnostic test as considered to be the "gold" standard for diagnosing tuberculosis? Computed tomography (CT) of the chest Complete blood count (CBC) CD4+ T-cell serum levels Sputum or bronchial cultures

Sputum or bronchial cultures

A 6-month-old infant has been hospitalized with acute bronchiolitis. Which treatment should be prioritized in the infant's care? Intravenous antibiotics Transfusion of fresh frozen plasma Tracheotomy Supplementary oxygen therapy

Supplementary oxygen therapy

A 20-year-old college student, with no past medical history, arrives at the emergency room complaining of severe palpitations and dizziness that started this morning following a night of studying. The student is very upset that this is happening because the final exams are the following day. The cardiac monitor shows a heart rate of 110, regular rhythm with occasional premature ventricular complexes. The nurse explains to the student that this can happen in healthy hearts and is usually caused by stimulation of: Vagal nerve Atrial ectopic foci Sympathetic nervous system Parasympathetic nervous system

Sympathetic nervous system

A client had a tuberculin skin test (TST) performed as part of the immigration process and is surprised that the results are positive. How should the nurse best interpret this result? The client has a genetic susceptibility to infection by Mycobacterium tuberculosis. The client has had contact with a person who has active or latent tuberculosis in the past 12 to 18 months. The client was exposed to the tubercle bacillus at an indefinite point in the past. The client will likely develop symptoms of primary tuberculosis within the next several months unless treated prophylactically.

The client was exposed to the tubercle bacillus at an indefinite point in the past. Explanation: A positive reaction to the TST does not mean that a person has active tuberculosis, only that there has been exposure to the bacillus and that cell-mediated immunity to the organism has developed. Tuberculosis has no genetic component to its etiology and a positive TST does not guarantee an active future infection. p 789 A client was admitted 3 days

A 32-year-old client has had a positive reaction to a tuberculin skin test and the duration of exposure is unknown. Which education will the nurse provide based on the most likely treatment course for this client? The client will need education about the administration of isoniazid and the importance of taking it as prescribed. The client will be required to take antibiotics for a minimum of 10 days. The client will be instructed to take ethambutol and pyrazinamide and be informed of the side effects. The client should be instructed that the urine will turn orange, as well as the tears.

The client will need education about the administration of isoniazid and the importance of taking it as prescribed.

A client has just been admitted to the cardiac intensive care unit with a diagnosis of infective endocarditis. His wife appears distraught and asks the nurse what caused this to happen to her husband. What would be the nurse's best response? Sometimes a parasite is involved. It can be attributed to drug abuse. The most common cause is a staph infection. Let's not worry about the cause as we need to focus on getting him better.

The most common cause is a staph infection.

A nurse who provides weekly care in a homeless shelter has unknowingly inhaled airborne Mycobacterium tuberculosis (TB) and has subsequently developed latent tuberculosis infection. Which statement is accurate regarding this nurse? The nurse has active TB infection. The nurse can spread TB to others. The nurse is likely asymptomatic. The nurse is now immune to more severe TB infection.

The nurse is likely asymptomatic.

A child is having symptoms of spasmodic croup after a previous bout for the same diagnosis. What care does the parent provide at home that demonstrates understanding of the education given by the nurse during this first bout of croup? Select all that apply. The parent takes a child outside in the cool air. The parent turns on the cold-water room humidifier in the child's room. The parent administers an antibiotic that was left over from the previous admission. The parent administers an antihistamine such as diphenhydramine. The parent brings the child into the bathroom where a warm shower is running to provide humidification.

The parent takes a child outside in the cool air. The parent turns on the cold-water room humidifier in the child's room. The parent brings the child into the bathroom where a warm shower is running to provide humidification.

A client presents with uncharacteristic chest pain, and his ECG reveals T-wave elevation. This finding suggests an abnormality with which aspect of the cardiac cycle? Atrial depolarization Ventricular depolarization Ventricular repolarization Depolarization of the AV node

Ventricular repolarization

A parent brings a child into the urgent care clinic. The health care provider suspects the child has a "common cold" based on which clinical manifestation(s)? Select all that apply. nuchal rigidity mild fever photosensitivity watery, clear nasal secretions coughing

Watery, clear nasal secretions Coughing Mild fever Explanation: The condition usually begins with a sore and scratchy throat followed by profuse and watery rhinorrhea, nasal congestion, sneezing, and coughing. Other cold symptoms include malaise, fatigue, headache, hoarseness, sinus congestion, and myalgia. Fever is a common sign in children. Photosensitivity and nuchal rigidity are signs of meningitis. p 782

A client has just been diagnosed with hypercholesterolemia and is asking what treatment will be needed. About which topics should the nurse educate the client? Select all that apply. Weight reduction if overweight Smoking cessation Dietary measures to reduce LDL levels Increased intake of fats and sodium Decreasing physical activity

Weight reduction if overweight Smoking cessation Dietary measures to reduce LDL levels

A client is prescribed an angiotensin-converting enzyme (ACE) inhibitor for treatment of hypertension. What expected outcome does the nurse expect this medication will have? Will increase oxygen consumption of the heart Will have a direct vasoconstrictive effect on vessels of splanchnic circulation Will increase extracellular fluid and decrease venous pressure Will prevent the conversion of angiotensin I to angiotensin II

Will prevent the conversion of angiotensin I to angiotensin II

A client is diagnosed with pneumoconiosis. Which aspect of the client's history is most likely the cause of this diagnosis? Exposed to tuberculosis recently Has congestive heart failure Worked in a coal mine for 20 years Has 20 pack-years history of smoking

Worked in a coal mine for 20 years

Which intervention will the nurse prioritize for the medical management of a client with a dissecting aortic aneurysm? administration of medication to increase blood pressure administration of epinephrine and intravenous fluids administration of vasodilators and beta-adrenergic blocking medications (beta-blockers) administration of pain medication and antianxiety medication

administration of vasodilators and beta-adrenergic blocking medications (beta-blockers)

The nurse is developing a plan of care for a postsurgical client. A major goal is to prevent the formation of deep vein thrombosis (DVT). Which nursing intervention should the nurse implement? ensure that the client remains on bed rest massage legs to maintain blood flow apply ice compresses to the site of the DVT hourly apply sequential pneumatic compression devices to lower extremities

apply sequential pneumatic compression devices to lower extremities

Which of the following are characteristic signs of acute arterial embolism? a. Pain, increased blood pressure, and warmth b. Pallor, pulselessness, and pain c. Paralysis, warmth, and paranoia d. Purpura, muscle weakness, and shortness of breath

b. Pallor, pulselessness, and pain

A client with a 25-year history of smoking is diagnosed with emphysema. Physical assessment reveals an increased anterior-posterior chest diameter. Which term should the nurse use to document this finding? pneumothorax blue bloater pink puffer barrel chest

barrel chest

The term chronic obstructive pulmonary disease (COPD) can be a combination of two types of obstructive airway diseases. Which disease processes have been identified as being part of COPD? chronic bronchitis and asthma emphysema and asthma chronic bronchitis and emphysema alpha1-antitrypsin deficit and emphysema

chronic bronchitis and emphysema the term chronic obstructive pulmonary disease encompasses two types of obstructive airway disease: emphysema, with enlargement of air spaces and destruction of lung tissue, and chronic obstructive bronchitis, with increased mucus production, obstruction of small airways, and a chronic productive cough. Persons with COPD often have overlapping features of both disorders.

A mother in premature labor asks the nurse why her doctor has prescribed corticosteroids. The nurse's response is based on the fact that: corticosteroids can perform anti-inflammatory acts that may prevent infections. cortisol administration will enhance the secretion of insulin, which is needed for surfactant production. corticosteroids cause blood glucose levels to rise, thus preventing hypoglycemia in premature infants. cortisol can accelerate maturation of type II cells and stimulate the formation of surfactant.

cortisol can accelerate maturation of type II cells and stimulate the formation of surfactant.

A client with asthma comes to the emergency department very anxious due to increasing shortness of breath. Physical assessment reveals tachypnea, and an arterial blood gas shows decreased carbon dioxide levels and hypoxemia. What is the most likely cause of the decreased carbon dioxide levels? apnea cyanosis tachycardia hyperventilation

hyperventilation

A client arrives at the emergency room with dizziness and a near syncopal episode. Vital signs include a heart rate of 46 beats/min and blood pressure of 86/50 mm Hg. The cardiac monitors show regular rhythm as above. The client states the health care provider has been running blood work to rule out hypothyroidism. Based on the rhythm, what does the nurse report the client has? Wolff-Parkinson-White syndrome symptomatic bradyarrhythmia symptomatic tachyarrhythmia symptomatic third-degree atrioventricular (AV) block

symptomatic bradyarrhythmia

With acute respiratory distress syndrome (ARDS), a client progressively increases his work of breathing. The physiologic principle behind this respiratory distress is related to: structural abnormalities of pulmonary vessels with proliferation of the vessel intima. the elevation of pulmonary venous pressure. the stiffening of the lung, making it more difficult to inflate. increases in left atrial pressure causing thickening of the lining of the pulmonary arteries.

the stiffening of the lung, making it more difficult to inflate.