M2 practice quiz
A client was admitted 3 days ago and is developing signs and symptoms of pneumonia. Select the correct documentation of the diagnosis.
Nosocomial pneumonia
A client is diagnosed with pneumoconiosis. Which aspect of the client's history is most likely the cause of this diagnosis?
Worked in a coal mine for 20 years
Upon admission assessment, the nurse hears a murmur located at the fifth intercostal space, midclavicular line. The client asks, "What does that mean?" The nurse will base her answer on which of the following physiologic principles? A- "You have a heart valve that is diseased." B- "You have been exposed to an infection that went into your blood stream." C- "You heart has been pumping your blood so hard, that the pressure has damaged your valves." D- "Your heart has enlarged, so naturally your valves had to enlarge as well."
"You have a heart valve that is diseased."
The nurse is reviewing the circulatory system. Which statements are correct about the functional organization of the circulatory system? Select all that apply.
-The arterial system distributes oxygenated blood to the tissues. -The venous system collects deoxygenated blood from the tissues.
The nurse knows that mean arterial pressure is:
60% diastolic pressure and 40% systolic pressure
In which situation is blood most likely to be rapidly relocated from central circulation to the lower extremities?
A client is helped out of bed and stands up
Valves in the veins prevent retrograde flow. In which veins are there no valves? Select all that apply.
Abdominal Thoracic
An adult comes to the urgent care clinic reporting facial pain, headache, and copious amounts of thick purulent nasal discharge. Based on these symptoms, the nurse practitioner suspects the client is experiencing which condition?
Acute viral rhinosinusitis
Dyspnea is defined as an uncomfortable sensation or difficulty in breathing that is subjectively defined by the client. Which disease state is not characterized by dyspnea?
Alzheimer disease
The nurse in the emergency department is assessing a toddler suspected of epiglottitis. Which intervention is considered the priority when working with this client?
Assess if airway is compromised and call for health care provider assistance with intubation to establish an airway, if needed.
Prolonged immobility is implicated in the development of which disorder?
Atelectasis and pulmonary embolism
A client awaiting a heart transplant is experiencing decompensation of the left ventricle that will not respond to medications. The health care provider (HCP) suggests placing the client on a ventricular assist device (VAD). The client asks what this equipment will do. Which response most accurately describes the purpose of a VAD?
Decreases the workload of the myocardium while maintaining cardiac output and systemic arterial pressure.
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?
Defibrillate the client
A client presents to the emergency department with a sudden onset of acute pain in his left lower leg. The practitioner is unable to palpate pedal pulses and finds the client to be in atrial fibrillation. Which test will the practitioner order to find the source of the emboli?
Echocardiogram
Which lab result strongly suggests an immunologic response in the client with possible rheumatic heart disease?
Group A (β-hemolytic) streptococcal antibodies
Release of which humoral factors will result in vasodilation?
Histamine
Ventilation is driven by which alteration in arterial blood?
Increased PCO2
A nurse is assessing a 1-year-old child diagnosed with croup. Which manifestation would most likely be present?
Inspiratory stridor and barking cough
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?
Low blood pressure
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?
Mycobacterium tuberculosis
When a client with a history of asthma takes a walk outside on a windy day with high pollen counts, she may experience an asthma attack, resulting in an increase in respiration rate and wheezing. The body's response is likely related to which pathophysiological principle? A- Influx of macrophages to wall of the pollen, thereby stopping the attack B- Release of catecholamines causing blood vessel constriction C- Inhibition of glandular secretions, which causes build up of mucus in the lungs D- Parasympathetic nervous system stimulation resulting in airway constriction
Parasympathetic nervous system stimulation resulting in airway constriction
A client has been admitted with bacterial pneumonia and is complaining of difficulty breathing. The nurse would explain the most likely reason for the dyspnea is that pneumonia interferes with lung compliance due to:
Pulmonary congestion
The nurse needs to assess the oxygen status of a client who is suddenly experiencing shortness of breath. The most appropriate noninvasive measurement technique would be:
Pulse oximetry
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:
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
The electrical activity of the heart is recorded on the ECG. What does the T wave on the ECG represent?
Repolarization of the ventricles
The nurse should anticipate administering intravenous antibiotic therapy as a priority to a client experiencing which type of shock?
Septic shock
During an assessment of a client with ankle swelling, the nurse observes jugular venous pulsations 5 cm above the sternal angle when the head of his bed is elevated 45 degrees. What is the correct interpretation of this finding?
The client has increased pressure related to right-sided heart failure.
The nurse is caring for the following clients. Select the client at highest risk for the development of atelectasis.
The client who is postoperative after a total knee replacement and receiving patient-controlled analgesia
With acute respiratory distress syndrome (ARDS), a client progressively increases his work of breathing. The physiological principle behind this respiratory distress is related to: A- The elevation of pulmonary venous pressure B- The stiffening of the lung, making it more difficult to inflate C- Increases in left atrial pressure causing thickening of the lining of the pulmonary arteries D- Structural abnormalities of pulmonary vessels with proliferation of the vessel intima
The stiffening of the lung, making it more difficult to inflate
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.
What is the function of the mucociliary blanket that lines the conducting airways?
To remove foreign materials
Which dysrhythmia is considered to be the most fatal and requires immediate treatment?
Ventricular fibrillation
A client with a diagnosis of secondary hypertension has begun to experience signs and symptoms that are consistent with decreased cardiac output. Which of the following determinants of cardiac output is hypertension most likely to affect directly? A- Afterload B- Heart rate C- Contractility D- Preload
afterload
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?
apply sequential pneumatic compression devices to lower extremities
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?
barrel chest
Select the correct sequence of blood return to the heart.
capillaries venules veins right atrium
A mother in premature labor asks the nurse why her doctor has prescribed corticosteroids. The nurse's response is based on the fact that:
cortisol can accelerate maturation of type II cells and stimulate the formation of surfactant.
A client admitted to the hospital with an exacerbation of chronic obstructive pulmonary disease (COPD) asks the nurse what can be done to decrease the dyspnea. The nurse instructs the client to use pursed-lip breathing (PLB) to help keep airways open by:
increasing intrapulmonary pressures.
A distressed, confused client is admitted to the hospital emergency department with a penetrating right chest stab wound. The nurse assesses the client and notes a lack of breath sounds in the right lung. The nurse knows this is likely the result of:
loss of intrapleural negative pressure.
Which of the following is most likely to precipitate an asthmatic attack in a child with a diagnosis of extrinsic, or atopic, asthma? A- Cold weather B- Stress C- Pet dander D- Respiratory tract infections
pet dander
A client has inhaled, drawing air into the oropharynx. From this location, air will:
proceed through the trachea, bronchi, and then bronchioles.
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?
pulmonary embolism
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?"
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?
Paroxysmal