Post test Med Surg 2

After surgical repair of a hip, which position is best for a patient's legs and hips? A. Abducted B. Adducted C. Prone D. Subluxated

Correct answer A: After surgical repair of the hip, the legs and hips should be in the abducted position. The adducted, prone and subluxated positions (Options B, C, and D) don't keep the prosthesis within the acetabulum.

While assessing a patient with dilated cardiomyopathy, the nurse notices that the ECG no longer has any P waves, only a fine wavy line. The ventricular rhythm is irregular, with a QRS duration of 0.08 second, and the heart rate is 110 beats/minutes. The nurse interprets this rhythm as: A. atrial fibrillation. B. ventricular fibrillation C. atrial flutter D. sinus tachycardia

Correct answer A: Atrial fibrillation is defined as chaotic, asynchronous, electrical activity in the atrial tissue. On an ECG, uneven baseline fibrillating waves appear rather than distinguishable P waves. Ventricular fibrillation(Option B) results in a chaotic rhythm with no QRS complexes. Atrial flutter (Option C) results in saw-tooth flutter waves. P waves are present in sinus tachycardia (Option D).

For a patient with peritonitis, which aspect of nursing care takes priority? A. Fluid and electrolyte balance B. Gastric irrigation C. Pain management D. Psychosocial care

Correct answer A: Because peritonitis can advance to shock and circulatory failure, fluid and electrolyte balance takes priority to maintain hemodynamic stability. Although the patient may periodically need gastric irrigation (Option B) to ensure patency of the nasogastric tube, pain management(Option C) for comfort, and psychsocial care(Option D) to address concerns such as anxiety, these don't take priority.

Which class of medications protects the ischemic myocardium by blocking catecholamines and sympathetic nerve stimulation? A. Beta-adrenergic blockers B. Calcium channel blockers C. Opioids D. Nitrates

Correct answer A: Beta-adrenergic blockers work by blocking beta receptors in the myocardium, reducing the response to catecholamines and sympathetic nerve stimulation. The protect the myocardium, helping to reduce the risk of another infarction by decreasing the workload of the heart by decreasing myocardial oxygen demand. Calcium channel blockers (Option B) reduce the workload of the heart by decreasing heart rate. Opioids(Option C) reduce myocardial oxygen demand, promote vasodilation and decrease anxiety. Nitrates (Option D) reduce myocardial oxygen consumption by decreasing left ventricular end-diastolic pressure (preload) and systemic vascular resistance(afterload).

A patient with acute asthma showing inspiratory and expiratory wheezes and a decreased forced expiratory volume should be treated with which class of medication right away? A. Bronchodilators B. Beta-adrenergic blockers C. Inhaled steroids D. Oral steroids

Correct answer A: Bronchodilators are the first line of treatment for asthma because bronchoconstriction is the cause of reduced airflow. Beta-adrenergic blockers (Option B) aren't used to treat asthma and can cause bronchoconstriction. Inhaled or oral steroids (Options C and D) may be given to reduce the inflammation but aren't for emergency relief.

When teaching a patient about cardiomyopathy, which statement by the patient indicates that further teaching is needed about the causes of cardiomyopathy? A. "It's caused by plaque in the arteries." B. "It's caused by a virus." C. "It's caused by bacteria." D. "It's caused by certain drugs."

Correct answer A: Cardiomyopathy isn't usually caused by plaque in the arteries or atherosclerosis. The etiology in most cases is a viral (Option B) or bacterial (Option C) infection of cardiotoxic effect of drugs(Option D) or alcohol.

Which patient is most at risk for developing deep vein thrombosis(DVT)? A. A 62 y/o female recovering from a total hip replacement. B. A 35 y/o female 2 days postpartum C. A 33y/o male runner with Achilles tendonitis D. An ambulatory 70y/o male who is recovering from pneumonia

Correct answer A: DVT is more common in immobilized patients who have had surgical procedures such as total hip replacement. Pregnancy(Option B) can cause varicose veins, which can lead to venous stasis, but it isn't a primary cause of DVT. A patient recovering from an injury (Option C) or pneumonia (Option D) may have decreased mobility but isn't at the highest risk for developing DVT.

Which sign or symptom typically occurs early in the development of multiple sclerosis (MS)? A. Diplopia B. Grief C. Paralysis D. Dementia

Correct answer A: Early indications of MS include slurred speech and diplopia. Grief(Option B) isn't a clinical manifestation. Paralysis(Option C) is a late symptom of MS. Although depression and a short attention span may occur, dementia (Option D) is rarely associated with MS.

A patient complains that he sees a green halo around lights. Upon reviewing the patient's medication list, the nurse determines that this is most likely caused by a high level of which medication? A. Digoxin B. Furosemide C. Metoprolol D. Enalapril

Correct answer A: One of the most common signs of digoxin toxicity is the visual disturbance know as the green halo sign. The other medications aren't associated with such an effect.

When giving emergency treatment to a patient with impending anaphylaxis secondary to a hypersensitivity to a drug, which action should the nurse take first? A. Administering oxygen B. Inserting an IV catheter C. Obtaining a CBC D. Taking vital signs

Correct answer A: The first action the nurse should take is administering oxygen. The nurse can then take vital signs (Option D) and immediately notify the physician. If the patient doesn't already have an IV catheter in place, the nurse can insert one (Option B) if anaphylactic shock is developing. Obtaining a CBC(Option C) wouldn't help resolve the emergency situation.

After teaching a patient about rheumatoid arthritis, which statement indicates that the patient understands the disease process? A. "It can get better and then worse again." B. "Once it clears up, it will never come back." C. "I will definitely have to have surgery for this." D. "It will never get any better than it is right now."

Correct answer A: the patient with rheumatoid arthritis needs to understand that the disease is somewhat unpredictable characterized by periods of exacerbation and remission. Although there's no cure (Option B), symptoms can be managed at times (Option D). Surgery (Option C) may be indicated in some cases, but not always.

A patient recalls smelling an unpleasant odor before his seizure. Which term describes this symptom? A. Atonic seizure B. Aura C. Icterus D. Postictal experience

Correct answer B: An aura occurs in some patients as a warning before a seizure. The patient may experience a certain smell, a vision such as flashing lights, or a sensation. Atonic seizure(Option A) or drop attack refers to an abrupt loss of muscle tone. Icterus(Option C) is another term for jaundice. During a postictal experience (Option D), which occurs after a seizure, the patient may be confused, somnolent, and fatigued.

Which action is the first priority when caring for a patient exhibiting signs and symptoms of coronary artery disease? A. Decreasing anxiety B. Enhancing myocardial oxygenation C. Administering sublingual nitroglycerin D. Educating the patient about his signs and symptoms

Correct answer B: Enhancing myocardial oxygenation is always the first priority when a patient exhibits signs or symptoms of cardiac compromise. Without adequate oxygen, the myocardium suffers damage. Decreasing the patient's anxiety (Option A), administering sublingual nitroglycerin to treat acute angina(Option C) and educating the patient (Option D) are important aspects of care delivery but don't take first priority.

Medications used to treat peptic ulcer disease such as ranitidine (Zantac) work by: A. neutralizing acid B. reducing acid secretion C. stimulating gastrin release D. protecting the mucosal barrier

Correct answer B: Histamine-2 receptor antagonists such as ranitidine reduce acid secretion; they work by inhibiting, not stimulating, gastrin secretion(Option C). Antacids neutralize acid (Option A), and mucosal barrier fortifiers protect the mucosal barrier(Option D).

Jugular vein distention is most prominent in which disorder? A. Abdominal aortic aneurysm B. Heart failure C. MI D. Pneumothorax

Correct answer B: Jugular vein distension results from elevated venous pressure and indicates a failure of the heart to pump. Jugular vein distention isn't a symptom of abdominal aortic aneurysm(Option A) or pneumothorax(Option D). Although a severe MI (Option C) can progress to heart failure, the MI itself doesn't cause jugular vein distention.

Which sign or symptom would a patient in the early stages of peritonitis exhibit? A. Abdominal distention B. Abdominal pain and rigidity C. Hyperactive bowel sounds D. Right upper quadrant pain

Correct answer B: Peritonitis is characterized by abdominal pain that causes rigidity of the abdominal muscles. Abdominal distention (Option A) may occur as a late sign but doesn't occur early on. Bowel sounds may be normal or decreased, not increased(Option C). Right upper quadrant pain (Option D) is characteristic of cholecystitis or hepatitis.

A nurse knows that the kidneys play an important role in regulating blood pressure. when hypertension occurs, which kidney responses help normalize blood pressure? A. Retaining sodium and excreting water B. Excreting sodium and water C. Retaining sodium and water D. Excreting sodium and retaining water

Correct answer B: The kidneys respond to a rise in blood pressure by excreting sodium and excess water. This response ultimately affects systolic blood pressure by regulating blood volume. Retaining sodium and water (Option C) would only further increase blood pressure. Sodium and water travel together across the membrane in the kidneys; one can't travel without the other (Options A and D).

What nursing action takes priority when caring for a patient hospitalized for acute cholecystitis? A. Administering antibiotics B. Assessing the patient for complications C. Preparing the patient for lithotripsy D. Preparing the patient for surgery

Correct answer B: The nurse should first assess this patient for such complications as perforation, fever, abscess, fistula, and sepsis; only after that should the nurse administer antibiotics(Option A) to reduce the infection. Surgery(Option D) is performed after the acute infection has subsided. Only a small percentage of these patients undergo lithotripsy(Option C).

A patient admitted with Parkinson's disease has an expressionless face and monotone speech. Which of the following observations by the nurse is most accurate? A. The patient is most likely depressed and should be left alone. B. These are common signs of Parkinson's disease. C. The patient's antipsychotic medication may need adjustment. D. The patient probably has dementia.

Correct answer B: The nurse should recognize that these are common signs of Parkinson's disease which results from degeneration of the substantia nigra in the basal ganglia of the brain where dopamine is produced and stored. This degeneration results in motor dysfunction. These aren't the typical signs of depression(Option A) or dementia (Option D). The effects fo antipsychotic medication(Option C) can mimic the extrapyramidal signs of Parkinson's disease, but these drugs aren't indicated for treating Parkinson's disease.

A patient has just returned from the postanesthesia care unit after undergoing internal fixation of a left femoral neck fracture. The nurse should place the patient in which position? A. On his left side with his right knee bent B. On his back with two pillows between his legs C. On his right side with his left knee bent D. Sitting at a 90-degree angle

Correct answer B: The operative leg must be kept abducted to prevent dislocation of the hip. Placing the patient on the left or right side with knee bent (Options A and C) doesn't promote abduction, and acute flexion of the operated hip may cause dislocation. The head of the bed may be raised 35 to 49 degrees, not 90 degrees (Option D).

A patient with thrombocytopenia secondary to leukemia develops epistaxis. What should the nurse instruct the patient to do? A. Lie supine with his neck extended B. Sit upright, leaning slightly forward C. Blow his nose and then put lateral pressure on it. D. Hold his nose while bending forward at the waist

Correct answer B: The upright position, leaning slightly forward, avoids increasing vascular pressure in the nose and helps the patient to avoid aspirating blood. Lying supine(Option A) won't prevent aspiration of blood. Nose blowing (Option C) can dislodge any clotting that has occurrence. Bending at the waist (Option D) increases vascular pressure and promotes bleeding rather than stopping it.

The heart rhythm of a patient in cardiac arrest undergoing cardiopulmonary resuscitation (CPR) deteriorates to ventricular fibrillation. Which action should the nurse take first? A. Administer 1mg of epinephrine IV. B. Defibrillate with a monophasic defibrillator at 360 joules. C. Continue CPR D. Administer 40 units of vasopressin IV

Correct answer B: To attempt to convert the rhythm, the nurse should first defibrillate the patient with a monophasic defibrillator at 360 joules. If this fails, then the nurse should continue CPR (Option C) for 2 minutes and attempt to defibrillate again. Epinephrine (Option A) and vasopressin (Option D) may be given, but not until after the first two defibrillation attempts.

A 165-lb (75kg) patient with a pulmonary embolus is ordered to receive 20 units/ kg/ hour of heparin by IV infusion. How many units of heparin should he receive each hour? A. 1,000 B. 1,200 C. 1,500 D. 1,700

Correct answer C: A 165-lb patient weighs 75 kg(2.2lb= 1 kg). 20 units x 75 kg x 1 hour= 1,500 units/hour.

After a right lower lobectomy for lung cancer, a patient returns to her room with a chest tube in place. The nurse formulates a care plan with a primary nursing diagnosis of Impaired gas exchange related to lung surgery. Which expected outcome is appropriate for this diagnosis? A. The patient will sit upright, leaning slightly forward. B. The patient will request pain medication as needed C. The patient will maintain a pulse oximetry level above 93% D. The patient will be pain-free.

Correct answer C: A pulse oximetry level above 93% and a normal respiratory rate demonstrate probable lung expansion and normal chest tube functioning. Sitting upright, leaning slightly forward(Option A) Suggests that the patient still has impaired gas exchange because this position increases lung expansion. Requesting pain medication as needed (Option B) and remaining pain-free(Option D) are expected outcomes for a nursing diagnosis of Acute Pain.

While assessing a patient's heart sounds, the nurse hears a murmur at the second left intercostal space along the left sternal border. Which valve is most likely involved? A. Aortic B. Mitral C. Pulmonic D. Tricuspid

Correct answer C: Abnormalities of the pulmonic valve are auscultated at the second left intercostal space along the left sternal border. Abnormalities of the aortic valve(Option A) are heard at the second intercostal space to the right of the sternum; of the mitral valve (Option B), at the fifth intercostal space in the midclavicular line; and of the tricuspid valve(Option D), at the third and fourth intercostal spaces along the sternal border.

According to The Seventh Report of the Joint National Committee of the Prevention, Detection, Evaluation, and Treatment of High Blood pressure(JNC7), what stage does a patient who has a continuous blood pressure reading of 142/90 mm Hg fall into? A. Stage 2 hypertension B. Prehypertension C. Stage 1 hypertension D. Normal

Correct answer C: According to JNC7, a systolic blood pressure of 140 to 159 mm Hg or a diastolic pressure of 90 to 99 mm Hg represents stage 1 hypertension. A systolic pressure greater than or equal to 160 mm Hg or diastolic pressure greater than or equal to 100mm Hg represents stage 2 hypertension(Option A). A systolic pressure of 120 to 139 mm Hg or diastolic pressure of 80 to 89 mm Hg represents prehypertension (Option B). A systolic pressure less than 120 mm Hg and diastolic pressure less than 80 mm Hg are considered normal (Option D).

While assessing a patient with disseminated intravascular coagulation (DIC), the nurse suspects the patient has developed internal bleeding. Which of the following signs indicates this condition? A. Hypertension B. Petechiae C. Increasing abdominal girth D. Bradycardia

Correct answer C: As blood collects in the peritoneal cavity, dilation and distention of the abdomen occur, causing an increase in abdominal girth. The The patient with DIC would have hypotension and tachycardia, not hypertension(Option A) and bradycardia(Option D). Petechiae(Option B) result when blood from tiny blood vessels leaks into the skin.

A patient's ABG results are as follows: pH, 7.16; partial pressure of arterial carbon dioxide (PaCO2), 80mm Hg; partial pressure of arterial oxygen (PaO2), 46 mm Hg; bicarbonate (HCO-3), 24 mEq/L; and arterial oxygen saturation (SaO2), 81%. These ABG values indicate which condition? A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis

Correct answer C: Because a patient's PaCO2 is high at 80 mm Hg and his metabolic measure (HCO3-) is normal, he has respiratory acidosis. If he had a HCO3_ below 22 mEq/L he would have metabolic acidosis(Option A). His pH is less than 7.35, indicating acidosis, which eliminates metabolic and respiratory alkalosis (Options B and D) as possibilities.

A hospitalized patient needs a central IV catheter inserted. The physician places the catheter in the subclavian vein. Shortly afterward, the patient develops shortness of breath and appears restless. Which action should the nurse perform first? A. Administer a sedative. B. Advise the patient to calm down C. auscultate for breath sounds D. Check to see if the patient can have medication

Correct answer C: Because this is an acute episode, the nurse should listen to the patient's lungs to see if anything has changed. The nurse shouldn't check to see if the patient can have medication(Option D), nor should she give this patient medication, especially a sedative (Option A), if he's having difficulty breathing. This patient is having an acute episode and giving him support rather than advising him to calm down (Option B) is more appropriate.

Instructions for a patient with systemic lupus erythematosus (SLE) should include information about which blood dyscrasia? A. Dressler's syndrome B. Polycythemia C. Essentials thrombocytopenia D. von Willebrand's disease

Correct answer C: Essential thrombocytopenia is linked with immunologic disorders, such as SLE and HIV. Dressler's syndrome(Option A) is pericarditis that occurs after an MI and isn't linked to SLE. Moderate to severe anemia is associated with SLE, not polycythemia(Option B). A type of hemophilia, von Willebrand's disease (Option D).isn't linked to SLE.

The nurse is auscultating the lungs of a patient following chest tube insertion. Which of the following results indicates correct chest tube placement? A. Bronchial sounds heard at both bases. B. Vesicular sounds heard over upper lung fields. C. Bronchovesicular sounds heard over both lung fields D. Crackles heard on the affected side.

Correct answer C: If the chest tube is inserted correctly, the nurse will hear normal bronchovesicular breath sounds in that area, and the patient's oxygenation status will improve;

A patient with cancer develops pleural effusion. During chest auscultation, which breath sounds should the nurse expect to hear? A. Crackles B. Rhonchi C. Diminished breath sounds D. Wheezes

Correct answer C: In pleural effusion, fluid accumulates in the pleural space, impairing transmission of normal breath sounds. Because of the acoustic mismatch, breath sounds are diminished. Crackles(short explosive or popping sounds)(Option A) commonly accompany atelectasis, interstitial fibrosis, and left-sided heart failure. Rhonchi (low-pitched sounds with a snoring quality) (Option B) suggest secretions in the large airways. Wheezes (high-pitched , hissing sounds) (Option D) result from narrowed airways, as in asthma, COPD, and bronchitis.

Which laboratory test result supports the diagnosis SLE? A. Elevated serum complement level B. Thrombocytosis and elevated sedimentation rate C. Pancytopenia and elevated antinuclear antibody (ANA) titer D. Leukocytosis and elevated blood urea nitrogen (BUN) and creatinine levels

Correct answer C: Laboratory findings for patients with SLE usually show pancytopenia, elevated ANA titer, and decreased serum complement levels, not elevated serum complement levels (Option A). Thrombocytosis and elevated sedimentation rate(Option B) are not diagnostic for SLE. Patients may have elevated BUN and creatinine levels(Option D) from nephritis, but the increase doesn't indicate SLE.

A patient with a pulmonary embolism may have an umbrella filter place in the vena cava for which reason? A. To prevent further clot formation B. To collect clots so that they do not reach the lungs C. To break up clots into insignificantly small pieces D. To slowly release an anticoagulant that dissolves any clots

Correct answer C: The umbrella filter is placed in a patient at high risk for the formation of more clots that could potentially become pulmonary emboli. It breaks the clots into small pieces that won't significantly occlude the pulmonary vasculature. The filter doesn't prevent further clot formation (Option A) or release anticoagulants(Option D). It also doesn't collect the clots (Option B); if it did, it would have to be emptied periodically, requiring further surgery.

To reduce occurrences of dumping syndrome, the nurse should instruct the patient to do which of the following? A. Sip fluids with meals B. Eat three meals daily C. Rest after meals for 30 minutes D. Follow a high-carbohydrate, low-fat, low-protein diet

Correct answer C: To reduce the occurrences of dumping syndrome, the patient should be taught to lie down after eating for 30 minutes; drink fluids only between meals, not with meals(Option A); eat smaller, more-frequent meals in a semi-recumbent position, not three meals a day(Option B); and avoid sweets and follow a low-carbohydrate, high-protein, moderate-fat diet, not a high-carbohydrate, low-fat, low protein diet(Option D).

Which blood test is the best indicator of myocardial injury? A. Lactate dehydrogenase (LD) B. A complete blood count (CBC) C. Troponin I D. Creatine kinase (CK)

Correct answer C: Troponin I levels rise rapidly and are detectable in people without cardiac injury. LD (Option A) is present in almost all body tissues and not specific to heart muscle, although LD isoenzymes may be useful in diagnosing cardiac injury. A CBC (Option B) is obtained to review blood counts, and a complete chemistry is obtained to review electrolytes. Because CK(Option D) is widely distributed in tissues, elevations in total serum CK lack specificity for cardiac damage.

During an assessment of a patient with a duodenal ulcer, the nurse finds that the patient experiences: A. early satiety B. pain when he eats C. dull upper epigastric pain D. pain when he has an empty stomach

Correct answer D: A patient with a duodenal ulcer feels pain when his stomach is empty; eating food or taking antacids relieves the pain. The other symptoms result from gastric ulcer.

During discharge teaching, which instruction should the nurse give to a patient diagnosed with pancreatitis? A. Consume high-fat meals. B. Consume low-calorie meals. C. Limit daily alcohol intake D. Avoid foods and beverages that contain caffeine.

Correct answer D: A patient with pancreatitis should avoid foods and beverages that can cause a relapse of the disease, including caffeine, which is a stimulant that will further irritate the pancreas. The patient should avoid all alcohol, not just limit his intake(Option C) because chronic alcohol use is one of the causes of pancreatitis. The patient should maintain a diet low in fats and high in calories, especially carbohydrates, not high in fats (Option A) or low in calories (Option B).

Which treatment is recommended for postoperative management of a patient who has undergone ligation and stripping? A. Sitting B. Bed rest C. Ice packs D. Elastic leg compression

Correct answer D: Elastic leg compression helps venous return to the heart, thereby decreasing venous stasis. Sitting(Option A) and bed rest(Option B) are contraindicated because both promote decreased blood return to the heart and venous stasis. Although ice packs (Option C) help reduce edema, they also cause vasoconstriction and impede blood flow.

Prevention and early treatment of Lyme's disease are crucial because late complications of this disease include: A. sterility B. renal failure C. lung abscess D. arthritis

Correct answer D: If Lyme disease goes untreated, arthritis, neurologic problems and cardiac abnormalities may arise as late complications. The first sign of Lyme disease is typically a skin lesion that enlarges and has a characteristic red border. However, not all patients develop this lesion. (Options A, B, and C) are incorrect because they aren't complications of Lyme disease.

Which measure can reduce of prevent the incidence of atelectasis in a postoperative patient? A. Chest physiotherapy B. Mechanical ventilation C. Reducing oxygen requirements D. Incentive spirometry

Correct answer D: Incentive spirometry requires the patient to take deep breaths and promotes lung expansion. Chest physiotherapy (Option A) helps mobilize secretions but won't prevent atelectasis. Placing the patient on mechanical ventilation (Option B) or reducing his oxygen requirements (Option C) won't affect the development of atelectasis.

Which of the following signs is one of the earliest indications of cardiogenic shock? A. Cyanosis B. Decreased urine output C. Presence of a fourth heart sound (S4) D. Altered LOC

Correct answer D: Initially, the decrease in cardiac output results in a decrease in cerebral blood flow that causes restlessness, agitation, or confusion. Cyanosis (Option A), decreased urine output(Option B), and presence of a fourth heart sound (Option C) are all later signs of shock.

Which of the following treatments would be most appropriate to relieve the pain of a patient admitted with DVT? A. Applying heat B. Bed rest C. Exercise D. Leg elevation

Correct answer D: Leg elevation alleviates the pressure caused by thrombosis and occlusion by assisting venous return. Applying heat(Option A) would dilate the vessels and pool blood in the area of the thrombus, increasing the risk of further thrombus formation. Bed rest(Option B) adds to venous stasis by increasing the risk of thrombosis formation. When DVT is diagnosed, exercise(Option C) isn't recommended until the clot has dissolved.

Which sign or symptom typically signifies rapid expansion and impeding rupture of an abdominal aortic aneurysm? A. Abdominal pain B. Absent pedal pulses C. Angina D. Lower back pain

Correct answer D: Lower back pain results from expansion of the aneurysm. The expansion causes pressure in the abdominal cavity, and the pain is referred to the lower back. Abdominal pain (Option A) is the most common symptom resulting from impaired circulation. Absent pedal pulses (Option B) are a sign of no circulation and occur after a ruptured aneurysm or in peripheral vascular disease. Angina (Option C) is associated with atherosclerosis of the coronary arteries.

The nurse is caring for a patient with a pleural effusion. The patient asks, "What is a pleural effusion?" Which of the following responses would be appropriate for the nurse to make? A. "It is the collapse of alveoli" B. "It is the collapse of a bronchiole" C. " It is the fluid in the alveolar space." D. "It is the accumulation of fluid between the linings of the pleural space."

Correct answer D: Pleural fluid normally seeps continually into the pleural space from the capillaries lining the parietal pleura and is reabsorbed by the visceral pleural capillaries and lymphatics. Any condition that interferes with either the secretion or drainage of this fluid can lead to a pleural effusion. The collapse of alveoli (Option A) or a bronchiole(Option B) has no particular name. Fluid within the alveolar space (Option C) isn't in the pleural space; such fluid accumulation can result from heart failure of adult respiratory distress syndrome.

A patient with a C6 spinal injury would most likely have which sign or symptom? A. Aphasia B. Hemiparesis C. Paraplegia D. Quadriplegia

Correct answer D: Quadriplegia occurs as a result of cervical spine injuries. Aphasia(Option A) refers to difficulty expressing or understanding spoken words. Hemiparesis (Option B) describes weakness of one side of the body. Paraplegia (Option C) occurs as a result of injury at or below the thoracic area of the spinal cord.

The nurse is assessing a patient's response to skeletal traction applied to the lower extremity. Which finding would be considered normal? A. Coolness and pallor below the fracture level. B. Erythema and swelling immediately around the pin insertion site C. Moderate to severe muscle spasms around the fracture area D. Serous drainage and crust formation at the pin insertion site.

Correct answer D: Serous drainage around the pin insertion site is a normal finding; some institutions don't recommend crust removal because of its protective nature. A pale, cool extremity(Option A) may indicate arterial compromise. Erythema and swelling(Option B) signal infection. Severe muscle spasms(Option C) may indicate improper alignment of the body or traction.

Preoperative teaching for the patient about to have surgery should focus on which area? A. Deciding if the patient should have the surgery B. Giving emotional support to the patient and his family C. Giving minute details of the surgery to the patient and his family. D. Providing general information to reduce patient and family anxiety

Correct answer D: The nurse's role is to provide general information about the surgery and what to expect before after surgery, and to give emotional support during this time. The nurse's role isn't to decide if the patient should have surgery (Option A) of to give minute details of the surgery(Option C). If the patient or family requests extremely detailed information, the surgeon should answer their questions. Emotional support alone(Option B) during this time isn't sufficient.

What information should the nurse include when teaching a patient about gout? A. Good foot care will reduce complications. B. The patient should be on a high-purine diet C. Uric acid production in the kidneys affects joints D. Uric acid crystals cause inflammatory destruction of the joint.

Correct answer D: The patient needs to know that uric acid crystals collect in the joint of the great toe and cause inflammation. The kidneys excrete uric acid, an end product of metabolism; they don't produce uric acid (Option C). The patient should be on a low-purine diet, not a high-purine diet (Option B). Good foot care (Option A) doesn't affect the development of complications.

Which physiologic effects of a pulmonary embolism would initially affect oxygenation? A. A blood clot blocks ventilation, but perfusion is unaffected. B. A blood clot blocks ventilation, producing hypoxia despite normal perfusion. C. A blood clot blocks perfusion and ventilation, producing profound hypoxia D. A blood clot blocks perfusion, producing hypoxia despite normal or supernormal ventilation.

Correct answer D: the blood clot blocks blood flow to a region of the lung tissue. That area remains ventilated, but because blood flow is blocked, no gas exchange can occur in that region, and a ventilation-perfusion mismatch occurs. Ventilation (Options A,B, and C) isn't initially affected by a blood clot because air can still move normally through the bronchial tree.