Exam #3
A client diagnosed with a ruptured appendix is at high risk for?
peritonitis
The nurse is preparing to auscultate a client's blood pressure. Which information obtained from the client would indicate that the nurse should wait 30 minutes prior to obtaining a reading?
the client just smoked a cigarette
The nurse knows that the primary long term regulation of blood pressure is exerted by which body system?
the kidneys
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
A patient is admitted with an abrupt onset of referred pain to the epigastric area, with an episode of nausea. On the nurse's initial assessment, the patient is lying still and taking shallow breaths, with a rigid abdomen. Which of the following problems is the patient experiencing?
peritonitis
A client is diagnosed with a tumor in the urinary bladder. The nurse will monitor the client for which of the following?
postrenal failure
The nurse recognizes that acute renal injury is characterized by which of the following?
rapid decline in renal function
The nursing instructor is teaching about cardiomyopathies in class. Which type does she tell the students is the most common cause occurring in young athletes?
genetic
The nurse is teaching a class on reduction of cardiovascular disease. Which action/activity demonstrates an intervention that is cognizant of the modifiable risk factors for hyperlipidemia?
going on a brisk walk with a friend
Exudate in the pericardial cavity is a characteristic of which cardiac condition?
pericardial effusion
A client with a history of cancer that metastasized to the liver has arrived at the outpatient clinic to have a paracentesis performed. The physician anticipates that the client will have more than 5 L of fluid removed. The physician has prescribed intravenous albumin following the procedure. The client asks why she needs "more fluids in my vein?" The nurse responds:
"Albumin is a volume expander. Since a lot of fluid was removed, you have a decrease in your vascular volume, so without this albumin, your kidneys will try to reabsorb and hold onto water."
What are the causes of CKD?
-hypertension -diabetes -glomerulonephritis
Which lipoprotein carries cholesterol?
LDL
Systolic hypertension has a bp of
140/90
The nurse knows that the main objective of the management of hypertension is to achieve a sustainable level of blood pressure below:
140/90
While studying the physiology of the heart, the nursing students have learned that which of the following influence the blood flow in the coronary vessels that supply the myocardium? Select all that apply.
-aortic pressure -autoregulatory mechanism -compression of the intromyocardial vessels
What are the causes of gastric carcinomas?
-environmental factors -family history -strain of H. pylori
A teenager is diagnosed with hypertension. The nurse knows that risk factors for hypertension in children and adolescents include which of these? Select all that apply.
-obesity -high salt consumption -inactive lifestyle
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.
-smoking cessation -dietary measures to reduce LDL levels -weight reduction if overweight
In hypovolemic shock, renal perfusion and urinary output decline. The nurse will monitor urinary output and knows that output below which level indicates inadequate renal perfusion?
20mL/hr
Which client should most likely be assessed for orthostatic hypotension?
An older adult client who has experienced two falls since admission while attempting to ambulate to the bathroom.
An older adult client is diagnosed with orthostatic hypotension. For which clinical manifestation should the nurse assess?
Dizziness and fainting
What is the most common risk factors for peptic ulcer disease?
H. pylori
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:
History of cigarette smoking and elevated blood pressure
A middle-aged adult is diagnosed with diverticular disease based on there recent complaints and the results of a computed tomography (CT) scan. Which of the client's statements demonstrates an accurate understanding of this diagnosis?
I suppose I should try to eat a bit more fiber in my diet.
When will the nurse plan to assess a client's blood pressure to confirm the possible diagnosis of orthostatic hypotension?
In the morning before arising from bed
When assessing a client with acute cholecystitis, the nurse anticipates the client's report of pain will be consistent with which of these descriptions?
Pain in the right upper quadrant referred to the same shoulder
A client with heart failure asks, "Why am I taking a 'water pill' when it's my heart that is having a problem?" While educating the client about the Frank-Starling mechanism, which explanation is most appropriate to share?
Since your heart is not pumping efficientyly, the kidneys are getting less blood flow; therefore, the kidneys are holding on to sodium and water"
A client has been diagnosed with aortic stenosis and asks the nurse what this means. The most appropriate response would be:
The valve opening is narrowed and produces increased resistance to blood flow out of the left ventricle and into the aorta.
Select the client at greatest risk for developing colorectal cancer.
a 64 yr old whose mother had colorectal cancer
Which client is at greatest risk for orthostatic hypotension?
a 66 year old postop client on bed rest
The primary care provider for a newly admitted hospital client has added the glomerular filtration rate (GFR) to the blood work scheduled for this morning. The client's GFR results return as 50 mL/minute/1.73 m2. The nurse explains to the client that this result represents:
a loss of over half the kidney function
A client with history of alcohol abuse is brought to the emergency department after a weekend of heavy drinking, experiencing right upper quadrant pain, anorexia, nausea, jaundice and ascites. The nurse identifies these as manifestations of what disorder?
alcoholic hepatitis
A 56-year-old male client has been diagnosed with hypercholesterolemia. Which laboratory results that support this diagnosis?
cholesterol: 250 HDL: 32
The pathophysiology of heart failure involves an interaction between decreased pumping ability and the ________ to maintain cardiac output.
compensatory mechanisms
A nurse is assessing a client in shock for complications of acute renal failure. Which assessment is priority for the nurse to obtain?
continuously measure urine output
An 80-year-old client with diabetes has a GFR of 41 mL/min/1.73 m2. His physical and workup show uremia, azotemia, and elevated BUN. Which action should be done first to slow the decline of his kidney function?
control blood glucose and BP
When an acute MI occurs, many physiologic changes occur very rapidly. What causes the loss of contractile function of the heart within seconds of the onset of an MI?
conversion from aerobic to anaerobic metabolism
The nurse is developing a plan of care for a client with heart failure. The most important information for the nurse to consider would be:
decrease cardiac output
A client is being treated for chronic kidney disease (CKD). One of the nurse's responsibilities is to explain to the client the need to keep her blood pressure under control. Why is blood pressure control so important in CKD clients?
elevated blood pressure will hurt the nephrons and cause renal failure
About a week after dental cleaning and root canal, a client has developed an infection of the thin, three-layered membrane that lines the heart and covers the valves. What is this client's most likely diagnosis?
endocarditis
Parents of a 20-month-old infant report that he refuses food or eats poorly and that he grimaces when he swallows. He also is irritable and cries a lot. The mother is worried that he ate something inappropriate this morning, because he vomited something that looked like coffee grounds. Which of the following health problems would the care team first suspect?
esophagitis from GI reflux
Cardiac tamponade and pericardial effusion can be life-threatening when the pericardial sac _______ and ______ the heart.
fills rapidly and compresses
What is the most important factor in myocardial oxygen demand?
heart rate
What causes acute gastritis?
high levels of NSAIDS
The health care provider is teaching a client about modifiable risk factors for atherosclerosis. The most appropriate information to provide would be:
hypertension
Which disorder is the leading cause of death in athletes?
hypertrophic cardiomyopathy
Increased cardiac workload with left sided heart failure can result in which change in myocardial cells?
hypertrophy
A client has just returned from his surgical procedure. During initial vital sign measurements, the nurse notes that the client's heart rate is 111 beats/minute and the BP is 100/78 (borderline low). In this early postoperative period, the nurse should be diligently monitoring the client for the development of:
hypovolemic shock due to acute intravascular volume loss
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:
improving the quality of life by relieving symptoms
Which statement regarding heart failure is true?
in compensated heart failure, an increase of end diastolic volume causes increased force of the left ventricle contraction
When caring for the client with hepatic failure, the nurse recognizes which of these problems places the client at increased risk for bleeding?
increase prothrombin time
What does the treatment for peptic ulcer disease do?
inhibits gastric acid production
What laboratory markers are most commonly used to diagnose acute pancreatitis?
lipase and amylase
Increased secretion of renin in heart failure is caused by which event?
low cardiac output
Which health condition can contribute to diastolic dysfunction heart failure?
myocardial hypertropthy
A client has developed cardiogenic shock. The most frequent cause of this type of shock is:
myocardical infarction
An ultrasound confirms appendicitis as the cause of a client's sudden abdominal pain. Which etiologic process is implicated in the development of appendicitis?
obstruction of the intestinal lumen
A client with postrenal acute kidney injury (AKI) exhibits oliguria and edema with laboratory results revealing increased levels of urea, potassium, and creatinine. Based on these data, which phase of AKI is this client most likely experiencing?
oliguric phase
The nurse understands the reason for the high mortality rate in stomach cancer is because of which of the following reasons?
patients have few early symptoms
A nurse is completing an abdominal assessment on a patient suspected to have appendicitis. When the nurse applies and then releases pressure in the patient's right lower quadrant, the patient experiences tenderness. The nurse is documenting the presence of which of the following?
rebound tenderness
The nurse assessing a client with a diagnosis of cholelithiasis will look for pain in which area?
right upper quadrant
The nurse is performing physical assessment of the gastrointestinal tract. In which of these areas does the nurse place the hands for palpation of the liver?
right upper quadrant
A 20-year-old college student being treated for a kidney infection developed a temperature of 104ºF (40°C) in spite of treatment with antibiotics. Her pulse was high, her blood pressure was low, and her skin was hot, dry, and flushed. The nurse knows that this client most likely is experiencing which type of shock?
septic
A health care provider suspects a client may have developed pancreatitis. Which laboratory value will confirm this diagnosis?
serum amylase and lipase
A client's blood pressure is persistently in the range of 130-135 mm Hg systolic and 85-88 mm Hg diastolic. The nurse knows that the client's blood pressure would be classified as which AHA definition?
stage 1 hypersensitivity
The nursing instructor is teaching the students about rheumatic fever. She tells the students that it is an important cause of heart disease and is very serious mainly for which reason?
the disabling effects that result from involvement of heart valves
A 16-year-old girl is hospitalized after ingesting 20 g of acetaminophen (Tylenol) in a suicide attempt. The care team would recognize that this client faces risk for which potential complication?
toxic hepatitis
A client with a suspected MI is brought to the emergency department by ambulance. The nurse caring for this client would expect to receive an order for which laboratory test to confirm a diagnosis of MI?
troponin level
What is the cause of colorectal cancer?
unknown
Levels of endothelins may be increased in clients with heart failure. Which of the following is the primary action of endothelins?
vasoconstriction
When assessing the client during the icteric phase of viral hepatitis, which of these findings does the nurse anticipate observing?
yellow tinged sclera