Midterm
Prehypertension
120-139/80-89
Stage I Hypertension
140-159/90-99
Stage II Hypertension
160+/100+
Normal ejection fraction
55-65%
A bank teller gets her blood pressure done at a health fair at work and is told that it is 150/92. She denies any history of hypertension and states she is not on medication for blood pressure, The nurse at the health fair should advise her to get her blood pressure rechecked within: A. A month B. A year C. Two years D. A week
A
A client has been having cardiac symptoms for several months and is seeing a cardiologist for diagnostics to determine the cause. How will the client's ejection fraction be measured? A. echocardiogram B. electrocardiogram C. cardiac catheterization D. cardiac ultrasound
A
A client is admitted to the health care facility with active tuberculosis (TB). The nurse should include which intervention in the care plan? A. Putting on an individually fitted mask when entering the client's room B. Instructing the client to wear a mask at all times C. Wearing a gown and gloves when providing direct care D. Keeping the door to the client's room open to observe the client
A
A client presents to a physician's office complaining of dyspnea with exertion, weakness, and coughing up blood. Further examination reveals peripheral edema, crackles, and jugular vein distention. The nurse anticipates the physician will make which diagnosis? A. Pulmonary hypertension B. Chronic obstructive pulmonary disease (COPD) C. Empyema D. Pulmonary tuberculosis
A
A nurse is caring for a client with heart failure. The nurse knows that the client has left-sided heart failure when the client makes which statement? A. "I sleep on three pillows each night." B. "My feet are bigger than normal." C. "My pants don't fit around my waist." D. "I don't have the same appetite I used to."
A
A nurse is developing a nursing care plan for a client for peripheral arterial disease. Which of the following will be the priority nursing diagnosis? A. Ineffective peripheral tissue perfusion B. Impaired tissue integrity C. Ineffective self-health management D. Ineffective thermoregulation
A
A perioperative nurse is conducting an in-service education program about maintaining surgical asepsis during the intraoperative period. Which of the following would the nurse emphasize? A. The edges of a sterile package, once opened, are considered unsterile. B. A distance of 3 feet must be maintained when moving around a sterile field. C. If a tear occurs in a sterile drape, a new sterile drape is applied on top of it. D. Circulating nurses may come in contact with the sterile field without contaminating it.
A
Patients with emphysema are most likely to have: A. Respiratory acidosis B. Respiratory alkalosis C. Metabolic acidosis D. Metabolic alkalosis
A
The ICU nurse is caring for a client who was admitted with a diagnosis of smoke inhalation. The nurse knows that this client is at increased risk for which of the following? A. Acute respiratory distress syndrome B. Lung cancer C. Bronchitis D. Tracheobronchitis
A
The client who had a total hip replacement was discharged home and developed acute groin pain in the affected leg, shortening of the leg, and limited movement of the fractured leg. The nurse interprets these findings as indicating which of the following complications? A. Dislocation of the hip B. Re-fracture of the hip C. Contracture of the hip D. Avascular necrosis of the hip
A
The nurse does an assessment on a patient who is admitted with a diagnosis of right-sided heart failure. The nurse knows that a significant sign is which of the following? A. Pitting edema B. Oliguria C. S3 ventricular gallop sign D. Decreased O2 saturation levels
A
The nurse is assessing a client who, after an extensive surgical procedure, is at risk for developing acute respiratory distress syndrome (ARDS). The nurse assesses for which most common early sign of ARDS? A. Rapid onset of severe dyspnea B. Inspiratory crackles C. Bilateral wheezing D. Cyanosis
A
The nurse is auscultating the patient's lung sounds to determine the presence of pulmonary edema. What adventitious lung sounds are significant for pulmonary edema? A. Crackles in the lung bases B. Low-pitched rhonchi during expiration C. Pleural friction rub D. Sibilant wheezes
A
The nurse is caring for a client with a spica cast. A priority nursing intervention is to: A. Keep the cast clean and dry. B. Position the client on the affected side. C. Promote elimination with a regular bedpan. D. Keep the legs in abduction.
A
The nurse recognizes which symptom as a classic sign of cardiogenic shock? A. Restlessness and confusion B. Hyperactive bowel sounds C. High blood pressure D. Increased urinary output
A
When developing a teaching plan for a patient scheduled for ambulatory surgery with epidural anesthesia, which of the following would the nurse include? A. "You shouldn't experience a headache after this type of anesthesia." B. "Normally, the blood pressure drops fairly low initially." C. "The anesthetic is introduced directly into the spinal cord." D. "You won't be able to move, but you'll be able to feel sensations."
A
Which comfort technique does a nurse teach to a client with pleurisy to assist with splinting the chest wall? A. Turn onto the affected side B. Use a prescribed analgesic C. Elevate the head of the bed D. Use a heat application
A
Which is a characteristic of right-sided heart failure? A. Jugular vein distention B. Dyspnea C. Pulmonary crackles D. Cough
A
Which of the following is a symptom diagnostic of emphysema? A. Dyspnea B. Copious sputum production C. Normal elastic recoil D. The occurrence of cor pulmonale
A
Which of the following terms refers to a muscular, cramp like pain in the extremities consistently reproduced with the same degree of exercise and relieved by rest? A. Intermittent claudication B. Aneurysm C. Ischemia D. Brtui
A
Which vitamin is usually administered with isoniazid (INH) to prevent INH-associated peripheral neuropathy? A. Vitamin B6 B. Vitamin C C. Vitamin D D. Vitamin E
A
The nurse assesses a patient with pneumonia and notes bronchial breath sounds over consolidated lung areas. Which of the following breath sounds are diagnostic for pneumonia? Select all that apply. A. Crackles B. Egophony C. Friction rubs D. Wheezes E. Whispered pectoriloquy F. Percussion dullness
A, B, E, F
A client has been experiencing increasing shortness of breath and fatigue. The health care provider has ordered a diagnostic test in order to determine what type of heart failure the client is having. What diagnostic test does the nurse anticipate being ordered? A. A chest x-ray B. An echocardiogram C. An electrocardiogram D. A ventriculogram
B
A client is brought to the emergency department following a motor vehicle accident. Which of the following nursing assessments is significant in diagnosing this client with flail chest? A. Respiratory acidosis B. Paradoxical chest movement C. Chest pain on inspiration D. Clubbing of fingers and toes
B
A nurse suspects that a client has digoxin toxicity. The nurse should assess for: A. hearing loss. B. vision changes. C. decreased urine output. D. gait instability.
B
A patient presents to the emergency department with difficulty breathing, cough with pink sputum and speaking in short 2-3 word sentences. What is the priority nursing intervention? A. Administer a diuretic B. Assess the patient's oxygen saturation C. Administer digoxin D. Ask the technician to get an electrocardiogram
B
Chronic bronchitis occurs as a result of the following except: A. Increased mucus production B. Skeletal muscle contraction C. Decreased macrophage function
B
On auscultation, which finding suggests a right pneumothorax? A. Bilateral inspiratory and expiratory crackles B. Absence of breath sounds in the right thorax C. Inspiratory wheezes in the right thorax D. Bilateral pleural friction rub
B
The nurse is caring for a client who sustained rib fractures in an automobile accident. What symptoms does the nurse recognize as a complication of rib fractures and should immediately be reported to the physician? A. Blood pressure of 140/90 mm Hg B. Crackles in the lung bases C. Client complains of pain in the affected rib area when taking a deep breath D. Heart rate of 94 beats/minute
B
The nurse is caring for a client with suspected right-sided heart failure. What would the nurse know that clients with suspected right-sided heart failure may experience? A. Increased urine output B. Gradual unexplained weight gain C. Increased perspiration D. Sleeping in a chair or recliner
B
The nurse knows that the most important assessment for a patient with status asthmaticus is: A. Monitoring cardiac rhythm B. Assessing airway patency C. Monitoring blood pressure D. Assessing urine output
B
The nurse performing an assessment on a patient who has arterial insufficiency of the legs and an ulcer on the left great toe would expect to find which of the following characteristics? A. Aching, cramping pain B. Diminished or absent pulses C. Pulses are present, may be difficult to palpate D. Superficial ulcer
B
The nurse teaches a patient with peripheral vascular disease (PVD) to refrain from smoking because nicotine causes which of the following? A. Diuresis B. Vasospasm C. Slowed HR D. Depression of the cough reflex
B
There are four stages of general anesthesia. Select the stage during which the OR nurse knows not to touch the patient (except for safety reasons) because of possible uncontrolled movements. A. Stage I: beginning anesthesia B. Stage II: excitement C. Stage III: surgical anesthesia D. Stage IV: medullary depression
B
What dietary recommendations should a nurse provide a client with a lung abscess? A. A diet low in calories B. A diet rich in protein C. A carbohydrate-dense diet D. A diet with limited fat
B
Which type of cast encloses the trunk and a lower extremity? A. Body cast B. Hip spica C. Long-leg D. Short-leg
B
Which of the following is accurate regarding the effects of nicotine and tobacco smoke on the body? Select all that apply. A. Decreases blood viscosity B. Causes vasospasm C. Impairs transport and cellular use of oxygen D. Reduces circulation to the extremities E. Increases blood viscosity
B, C, D, E
Hypertensive urgency
BP elevated without evidence of impending organ damage
A client is undergoing a lumbar puncture. The nurse educates the client about surgical positioning. Which statement by the nurse is appropriate? A. "You will be placed flat on the table, face down." B. "You will be on your back with the head of the bed at 30 degrees." C. "You will be lying on your side with your knees to your chest." D. "You will be flat on your back with the table slanted so your head is below your feet."
C
A patient diagnosed with pre-hypertension verbalizes understanding of modifiable behaviors by: A. Increasing potassium intake B. Limiting alcohol intake to 3-4 drinks/day C. Joining a weight loss program D. Limiting cigarette smoking to less than a pack/day
C
A patient has been diagnosed with prehypertension and has been encouraged to exercise regularly and begin a weight loss program. After what period of time does the nurse tell the patient to return for a follow-up visit? A. 2 months B. 6 months C. 1 year D. 2 years
C
A patient in the ED states, "I have always taken a morning walk, but lately my leg cramps and hurts after just a few minutes of walking. The pain goes away after I stop walking, though." Based on this statement, which priority assessment should the nurse complete? A. Assess for unilateral swelling and tenderness of either leg B. Ask about any skin color changes that occur in response to cold C. Attempt to palpate the dorsalis pedis and posterior tibial pulses D. Check for the presence of toruous veins bilaterally on the legs
C
Aging is positively correlated to the incidence of hypertension. This is due to three of the following four structural or functional changes. Which choice is not considered a cause? A. Atherosclerosis B. Decreased elasticity of the major blood vessels C. Increased ability to exert diastolic pressure D. Increased arterial resistance to left ventricular ejection
C
Cystic fibrosis can cause all of the following EXCEPT: A. Bronchiectasis B. Pancreatitis C. Memory loss D. Infertility
C
On assessment, the nurse knows that a patient who reports no symptoms of heart failure at rest but is symptomatic with increased physical activity would have heart failure classified as Stage: A B C D
C
Patients with heart failure knows that they should contact their primary care provider if: A. They gain 2-3 pounds in one week B. They gain 5 pounds in two weeks C. They gain 2-3 pounds in one day D. They gain 1.5 pounds in one day
C
The nurse is administering nitroglycerin, which he knows decreases preload as well as afterload. Preload refers to which of the following? A. The amount of resistance to the ejection of blood from the ventricles B. The force of the contraction related to the sympathetic nervous system C. The amount of blood presented to the ventricles just before systole D. Fluid overload and tissue perfusion status
C
The nurse is caring for a patient who has started anticoagulant therapy with warfarin (Coumadin). When does the nurse understand that therapeutic benefits will begin? A. Within 12 hours B. Within the first 24 hours C. In 3 to 5 days D. In 2 days
C
The nurse is educating a patient who will be started on an antituberculosis medication regimen. The patient asks the nurse, "How long will I have to be on these medications?" What should the nurse tell the patient? A. 3 months B. 3 to 5 months C. 6 to 12 months D. 13 to 18 months
C
The term for a diagnostic test that involves injection of a contrast media into the venous system through a dorsal vein in the foot is which of the following? A. Lymphoscintigraphy B. Air plethysmography C. Contrast phlebography D. Lymphangiography
C
When measuring the blood pressure in each arm of a healthy adult client, the nurse recognizes that which statement is true? A. Pressures must be equal in both arms. B. Pressures may vary 10 mm Hg or more between arms. C. Pressures should not differ more than 5 mm Hg between arms. D. Pressures may vary, with the higher pressure found in the left arm.
C
A client has been diagnosed with peripheral arterial occlusive disease. Which of the following instructions is appropriate for the nurse to give the client for promoting circulation to the extremities? A. Keep the extremities elevated slightly B. Massage the calf muscles if pain occurs C. Use a heating pad to promote warmth D. Participate in a regular walking program
D
A patient comes to the clinic with fever, cough, and chest discomfort. The nurse auscultates crackles in the left lower base of the lung and suspects that the patient may have pneumonia. What does the nurse know is the most common organism that causes community-acquired pneumonia? A. Staphylococcus aureus B. Mycobacterium tuberculosis C. Pseudomonas aeruginosa D. Streptococcus pneumoniae
D
A physician orders digoxin (Lanoxin) for a client with heart failure. During digoxin therapy, which laboratory value may predispose the client to digoxin toxicity? A. Magnesium level of 2.5 mg/dl B. Calcium level of 7.5 mg/dl C. Sodium level of 152 mEq/L D. Potassium level of 2.8 mEq/L
D
After diagnosing a client with pulmonary tuberculosis, the physician tells family members that they must receive isoniazid (INH [Laniazid]) as prophylaxis against tuberculosis. The client's daughter asks the nurse how long the drug must be taken. What is the usual duration of prophylactic isoniazid therapy? A. 3 to 5 days B. 1 to 3 weeks C. 2 to 4 months D. 6 to 12 months
D
Conservative treatment of a compressed nerve root is first line treatment. What conservative treatment is used to increase the distance between vertebrae and decrease severe muscle spasm? A. Skeletal traction B. Sleeping on a hard mattress with a bed board C. Cool, moist compresses D. Skin traction
D
The nurse caring for a patient who is at risk for malignant hyperthermia subsequent to general anesthesia would assess for the most common early sign of: A. Hypertension (BP >130/90). B. Tachypnea (>35 breaths/min). C. Oliguria (urinary output <400 mL/day). D. Tachycardia (HR >150 bpm).
D
The nurse taking care of a patient with left-sided heart failure knows that the patient could have all of the following except: A. Low oxygen saturation B. Cough with pink sputum C. Dyspnea D. Jugular venous distention
D
While working out, Sarah knows it is important to have what type of medication ready if she starts to experience difficulty breathing for immediate relief: A. Fluticasone (inhaled corticosteroid) B. Salmeterol (long acting beta2-agonist) C. Fluticasone/salmeterol (combined corticosteroid and long acting beta agonist) D. Albuterol (short acting beta2-agonist)
D
First line pharmacologic therapy for TB
INH, Rifampin, Pyrazinamide, Ethambutol
Which is a benefit of a continuous passive motion (CPM) device when applied after knee surgery?
It promotes healing by increasing circulation and movement of the knee joint
Stage III Heart Failure
Marked limitation of physical activity; comfortable at rest, but less than ordinary activity causes fatigue, palpitation, or dyspnea
Stage I Heart Failure
No limitation of physical activity; ordinary activity does not cause fatigue, palpitation, or dyspnea
Acute Respiratory Failure
PaO2 <60 mmHg PaCO2 >50 mmHg pH <7.35
Stage II Heart Failure
Slight limitation of physical activity; comfortable at rest, but ordinary physical activity causes fatigue, palpitation, or dyspnea
Which device is designed specifically to support and immobilize a body part in a desired position?
Splint
Acute viral rhinosinusitis symptoms (AVRS)
Symptoms less than 10 days; milder presentation of symptoms; no high fever
Acute bacterial rhinosinusitis symptoms (ABRS)
Symptoms of 10 days or more; high fever; purulent nasal drainage
Stage IV Heart Failure
Unable to carry out any physical activity without discomfort; symptoms of cardiac insufficiency at rest
Atrophic chronic pharyngitis
a late stage of the hypertrophic type where the membrane is thin, whitish, glistening, and at times wrinkled
Beta-blockers
block effects of adrenaline on heart and arteries; keeps blood pressure low
Angiotensin receptor blockers
blocks vasoconstricting effects of angiotensin II; alternative to ACE inhibitors
Angiotensin-converting inhibitors
decrease BP and decrease afterload
Hypertensive emergency
elevated BP to > 180 SBP and/or >120 DBP; organ damage is present
alpha1-antitrypsin
enzyme inhibitor that protects the lung parenchyma from injury
Hypertrophic chronic pharyngitis
general thickening and congestion of the pharyngeal mucous membrane
Rhinitis
mucus is discharged
Chronic granular pharyngitis
numerous swollen lymph follicles on the pharyngeal wall
5 P's
pain, pallor, pulselessness, paresthesia, paralysis
Rhinosinusitis
thick mucus occludes the sinus cavity which prevents drainage