prepU 2

The nurse determines that teaching has been effective when a client diagnosed with chronic stable angina (CSA) states: "Because it is chronic angina, it will not get worse." "Angina may result from exertional activity or emotional stress and be relieved within minutes by rest or by nitroglycerin." "If it takes longer than 5 to 10 minutes for relief of symptoms after I take my Nitro, I am improving." "If the angina occurs when I am resting, I do not need to worry."

"Angina may result from exertional activity or emotional stress and be relieved within minutes by rest or by nitroglycerin."

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 young, male child is born with severe respiratory failure. Over the course of months, the parents note his body looks swollen. They ask, "Are our baby's kidneys not working right? Why is he so swollen?" The nurse bases the reply on which physiologic principles? "The right side of his heart (cor pulmonale) is not pumping effectively. Blood is backlogging in his body, which is why he is so swollen." "This happens when he has so many secretions in his lungs. Maybe we should try some expectorant to thin his secretions so he can cough them out." "We just need to call the physician and ask him to give you a prescription for more water pills." "Once we get his oxygenation level back to normal, then maybe his kidneys will receive enough oxygenated blood to filter better."

"The right side of his heart (cor pulmonale) is not pumping effectively. Blood is backlogging in his body, which is why he is so swollen."

A pediatrician is teaching a group of medical students about some of the particularities of heart failure in children as compared with older adults. Which statement by the physician bestcaptures an aspect of these differences? "Signs and symptoms in children may sometimes mimic those of shock, with a low blood pressure and high heart rate." "Because of their higher relative blood volume, jugular venous distention is a better assessment technique for suspected heart failure in young clients." "Fever is a sign of heart failure in children that you are unlikely to see in older adults." "You'll find that, in pediatric clients, pulmonary edema is more often interstitial rather than alveolar, so you often won't hear crackles."

"You'll find that, in pediatric clients, pulmonary edema is more often interstitial rather than alveolar, so you often won't hear crackles."

What description is characteristic of the pathology of chronic bronchitis? Airways are obstructed by mucus, causing hypoxemia. Airways constrict and become narrower, causing wheezing and cyanosis. Airways become stiff and resist expansion, leading to hypoxemia. Airway expansion is restricted by external pressures, leading to hypercapnia.

Airways are obstructed by mucus, causing hypoxemia.

Which long-term care resident is most likely to be exhibiting the signs and symptoms of chronic obstructive pulmonary disease (COPD)? An 88-year-old female who experiences acute shortness of breath and airway constriction when exposed to tobacco smoke. An 81-year-old male who has a productive cough and recurrent respiratory infections. An 81-year-old smoker who has increased exercise intolerance, a fever, and increased white blood cells. A 79-year-old lifetime smoker who reports shortness of breath and pain on deep inspiration.

An 81-year-old male who has a productive cough and recurrent respiratory infections

The nurse is developing a plan of care for a postsurgical client. A major goal is to prevent the formation of prevent deep vein thrombosis (DVT). The most important intervention for the nurse to implement would be: Apply sequential pneumatic compression devices to lower extremities. Massage legs to maintain blood flow. Apply ice compresses to the site of the DVT hourly. Ensure that the client remains on bed rest.

Apply sequential pneumatic compression devices to lower extremities.

The nursing instructor, when teaching the students about coronary artery disease (CAD), identifies which of the following as the the main cause of CAD? Excessive exercise Defect in the DNA Atherosclerosis Excessive use of dairy products

Artherosclerosis

A female older adult client has presented with a new onset of shortness of breath, and the client's physician has ordered measurement of her brain natriuretic peptide (BNP) levels along with other diagnostic tests. What is the most accurate rationale for the physician's choice of bloodwork? BNP is an indirect indicator of the effectiveness of the renin-angiotensin-aldosterone (RAA) system in compensating for heart failure. BNP is released as a compensatory mechanism during heart failure and measuring it can help differentiate the client's dyspnea from a respiratory pathology. BNP becomes elevated in cases of cardiac asthma, Cheyne-Stokes respirations and acute pulmonary edema, and measurement can gauge the severity of pulmonary effects. BNP levels correlate with the client's risk of developing cognitive deficits secondary to heart failure and consequent brain hypoxia.

BNP is released as a compensatory mechanism during heart failure and measuring it can help differentiate the client's dyspnea from a respiratory pathology.

Persistent cyanosis has led an infant's care team to suspect a congenital heart defect. Which assessment findings would suggest coarctation of the infant's aorta? The child experiences apneic spells after feeding. ECG reveals atrial fibrillation. The child has a split S2 heart sound on auscultation. Blood pressure in the child's legs is lower than in the arms.

Blood pressure in the child's legs is lower than in the arms

A client who was hospitalized with bacterial pneumonia has now developed an infection in the pleural cavity. Which terminology correctly identifies this pathophysiologic finding? Pneumothorax Empyema Hemothorax Chylothorax

Empyema

Which diagnosis places a child at the greatest risk for airway obstruction? Epiglottitis Bronchiolitis Syncytial virus (RSV) Croup

Epiglottitis

A nurse is assessing a client's apical pulse. The nurse is palpating the point of maximum impulse between which ribs? Fourth and fifth Second and third Third and fourth Fifth and sixth

Fifth and sixth

Football fans at a college have been shocked to learn of the sudden death of a star player, an event that was attributed in the media to "an enlarged heart." Which disorder was the player's most likely cause of death? Hypertrophic cardiomyopathy (HCM) Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) Takotsubo cardiomyopathy Dilated cardiomyopathy (DCM)

Hypertrophic cardiomyopathy (HCM)

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 priorityintervention at this time? Administration of atropine Synchronized cardioversion Applying a transcutaneous pacemaker Immediate defibrillation

Immediate defibrillation

The nurse is reviewing a client's history and recognizes that the client smokes cigarettes. The nurse is concerned because smoking does which of the following? Injures the endothelial cells lining the blood vessels, thereby promoting thrombus development Increases serum HDL levels, thereby promoting fat oxidation Promotes vasodilation and decreases peripheral resistance, thereby increasing cardiac workload Decreases serum lipid levels and increases inflammation, thereby promoting hyperlipidemia

Injures the endothelial cells lining the blood vessels, thereby promoting thrombus development

A nurse is instructing a class for people with newly diagnosed asthma to encourage healthy lifestyle choices. The nurse explains that stimulation of certain lung receptors with things such as smoke, cigarette smoke, inhaled dust, or cold air can lead to constriction of the conducting airways resulting in rapid, shallow breathing. How does the nurse identify these receptors? Stretch receptors Noxious receptors J receptors Irritant receptors

Irritant receptors

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 Gastrointestinal relaxation Laryngeal edema Uterine smooth muscle relaxation

Laryngeal edema

The home care nurse is caring for a client who has sustained phrenic nerve damage from a skiing accident. The nurse understands that the client must be on a ventilator for which reason? Dysfunction of the accessory muscles Negative intrapleural pressures Positive intrathoracic pressures Loss of diaphragmatic function

Loss of diaphragmatic function

A nurse is assessing a female client and notes that her left arm is swollen from the shoulder down to the fingers, with non-pitting edema. The right arm is normal. The client had a left-sided mastectomy 1 year ago. What does the nurse suspect is the problem? Deep vein thrombosis Arteriosclerosis Venous stasis Lymphedema

Lymphedema

The nurse is monitoring trends in the client's arterial blood gases and recognizes that changes in ventilation will result from which of the following? Select all that apply. Oxygen pH Carbon dioxide Cerebrospinal fluid (CSF) Anion gap

Oxygen pH Carbon dioxide

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 Pericardial effusion Pericarditis COPD

Pericardial effusion

A client recently had surgery for a hip fracture. Which nursing intervention would be mosteffective for preventing pulmonary emboli in this client? Encourage increase fluid intake Use of oxygen and incentive spirometer following surgery Monitor hematocrit and hemoglobin levels Prevention of the development of a deep vein thrombosis

Prevention of the development of a deep vein thrombosis

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 Establishing IV access and administering sulfa antibiotics as ordered Providing a low-stimulation environment to relieve bronchospasm Administering antiviral medications such as zanamivir and oseltamivir as ordered

Providing cool, moist air for the child to breathe

A client presents to the emergency department reporting bilateral cyanosis and pallor of the fingers after being out in the cold weather for 5 minutes. The toes are of normal color. What is a potential diagnosis for this client? Deep vein thrombosis Frostbite related to hypothermia Atherosclerotic occlusive disease Raynaud disease

Raynaud disease

A client diagnosed with the common cold has been taking an over-the-counter antihistamine for the control of symptoms. What should the client be aware may occur if the drugs are used too frequently over too many days? Sinusitis Pneumonia Rebound symptoms Nasal polyps

Rebound symptoms

A client has prominent jugular veins. What type of medical problem is associated with prominent jugular veins? Shock Left-sided heart failure Cerebrovascular accident (stroke) Right-sided heart failure

Right-sided heart failure

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) Anticholinergic medications such as ipratropium Anti-inflammatory agents such as sodium cromolyn Oral corticosteroids

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

An IV drug abuser walks into the ED telling the nurse, "I am sick." The client looks feverish with flushed, moist skin; dehydrated with dry lips/mucous membranes; and fatigued. The assessment reveals a loud murmur. An echocardiogram was ordered that shows a large vegetation growing on the client's mitral valve. The client is admitted to ICU. The nurse will be assessing this client for which possible life-threatening complication? GI upset from the massive amount of antibiotics required to kill the bacteria. Systemic emboli, especially to brain. Pancreas enlargement due to increased need for insulin secretion. Petechial hemorrhages under the skin and nail beds.

Systemic emboli, especially to brain.

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 can spread TB to others. The nurse has active TB infection. The nurse is likely asymptomatic. The nurse is now immune to more severe TB infection.

The nurse is likely asymptomatic.

The parents of a child with cystic fibrosis ask the nurse to explain the sweat test performed on their newborn. How should the nurse respond? Abnormal pancreatic enzymes may cause the infant to sweat more. The sweat test evaluates the infant's ability to sweat in response to heat. Cystic fibrosis decreases the amount of salt in the infant's sweat. The sweat test measures the concentration of salt in the infant's sweat.

The sweat test measures the concentration of salt in the infant's sweat.

A client is told that she has cardiac valve leaflets, or cusps, that are floppy and fail to shut completely, permitting blood flow even when the valve should be completely closed. The nurse knows that this condition can lead to heart failure and is referred to as: Pericardial effusion Valvular stenosis Valvular regurgitation Infective endocarditis

Valvular regurgitation

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

insertion of a large-bore needle or chest tube.

the heart is a fourchambered pump. what is the function of the right ventricle

pump blood to the lungs

Assessment of an older adult client reveals bilateral pitting edema of the client's feet and ankles; difficult to palpate pedal pulses; breath sounds clear on auscultation; oxygen saturation level of 93% (0.93); and vital signs normal. What is this client's most likely health problem? right-sided heart failure cardiogenic shock pericarditis cor pulmonale

right-sided heart failure

A client in the intensive care unit died shortly after developing multiple organ dysfunction syndrome (MODS). Which health problem most likely preceded the client's MODS? Disseminated intravascular coagulation Sepsis Heart failure Acute renal failure

sepsis