Patho Exam Three

A client has suffered a head injury during a motorcycle accident resulting in impaired swallowing and aspiration pneumonia. Which statement most accurately captures an aspect of his condition? A. His vocal folds of the larynx are not performing their normal function. B. His epiglottis is covering his larynx C. His trachea has been compromised D. His tracheobronchial tree is intermittently obstructed.

A. His vocal folds of the larynx are not performing their normal function.

The nurse is caring for several clients. Given the typical treatments for each of the listed client conditions, which client should the nurse prioritize as most at risk for acute gastrointestinal bleeding? A. A 65-year-old client being treated for atrial fibrillation and coronary artery disease B. A 45-year-old with hypertension and type 2 diabetes being treated for a foot ulcer C. A 70-year-old with rheumatoid arthritis being treated for pneumonia D. An 85-year-old with failure to thrive who is confused and receiving intravenous fluids

A. A 65-year-old client being treated for atrial fibrillation and coronary artery

A client, admitted after an automobile accident in which their head and chest hit the steering wheel, has a combination of biomarker testing. The family asks, "why are there so many blood tests?" The response by the nurse reveals these test results will confirm the client has developed which conditions? Select all that apply A. Acute lung injury B. Pulmonary embolism C. Pulmonary hypertension D. Acute respiratory distress syndrome (ARDS) E. Pneumothorax

A. Acute lung injury D. Acute respiratory distress syndrome (ARDS)

A nurse is caring for a 67-year-old client who has been diagnosed with pneumonia. The vital signs are Temp 101.7, BP 155/95, RR 26, and HR 88. Which interventions should the nurse incorporate into the client's plan of care? Select all that apply. A. Administer antipyretics as ordered B. Administer antitussives as ordered C. Encourage deep breathing and coughing D. Elevate the client's legs periodically E. Encourage fluid intake

A. Administer antipyretics as ordered C. Encourage deep breathing and coughing E. Encourage fluid intake

For several years, a single mother of 2 has been averaging 2 to 3 bottles of wine each night and recently has added several ounces of brandy as well. She now has been diagnosed with cirrhosis. Which physical manifestations of cirrhosis would the nurse expect to find during assessment? Select all that apply. A. Ascites B. Anorexia C. Fever D. Bleeding tendencies E. Epigastric pain F. Obesity

A. Ascites B. Anorexia D. Bleeding tendencies E. Epigastric pain

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

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

A client who is experiencing some angina associated with atrial tachycardia has been placed on verapamil, a calcium-channel blocker. Knowing that this medication blocks the slow calcium channels, thereby depressing phase 4 and lengthening phases 1 and 2 action potential, the nurse should assess this client for which adverse reaction? A. Bradycardia B. Ventricular tachycardia C. Sudden cardiac death D. Increased cardiac output

A. Bradycardia

A client who is on several medications has noticed an increase in gastrointestinal infections. What type of medication should the nurse advise the client to discuss with the health care provider as a possible cause for increased gastrointestinal infections? A. Broad-spectrum antibiotics B. Beta-1 selective adrenergic blocker C. H1 receptor blocker D. Enteric-coated aspirin

A. Broad-spectrum antibiotics

A client with kidney cancer who underwent exploratory surgery has returned to the postoperative unit with a report of severe burning and indigestion in the epigastric region. Which intervention by the nurse would be priority for this client? A. Call the surgeon for a prescription for a proton pump inhibitor (PPI) to prevent stress ulcer development. B. Sit the client up in a high-Fowler position and give ice chips to suck on. C. Call the dietary team to bring some milk products to the floor to counter excess gastric acid. D. Administer prescribed pain medications and dim the lights in the room.

A. Call the surgeon for a prescription for a proton pump inhibitor (PPI) to prevent stress ulcer development.

A client is admitted with the diagnosis of obstructive jaundice. Which assessment findings would the nurse expect to see in this client? Select all that apply. A. Clay-colored stools B. Dark urine C. Elevated conjugated bilirubin levels D. Decreased serum alkaline phosphatase levels E. Severe itching

A. Clay-colored stools B. Dark urine C. Elevated conjugated bilirubin levels E. Severe itching

The nurse is caring for a client with end-stage liver disease who is at risk for hepatic encephalopathy. For which complications that increase the risk for hepatic encephalopathy should the nurse assess? Select all that apply. A. Constipation B. Gastrointestinal bleeding C. High colonic pH D. Hypoalbuminemia E. Hyponatremia

A. Constipation B. Gastrointestinal bleeding C. High colonic pH

A 28-year-old man presents with reports of diarrhea, fecal urgency, and weight loss. His stool is light-colored and malodorous, and it tends to float and be difficult to flush. He has also noted tender, red bumps on his shins and reports pain and stiffness in his elbows and knees. Sigmoidoscopy reveals discontinuous, granulomatous lesions; no blood is detected in his stool. Which diagnosis would his care team first suspect? A. Crohn disease B. Ulcerative colitis C. Diverticulitis D. Colon cancer

A. Crohn disease

A client reports having diarrhea that has lasted days. Which intervention would the nurse recommend to decrease the diarrhea? A. Electrolyte drink containing sodium and glucose B. Diet soda C. Water D. Drink with caffeine

A. Electrolyte drink containing sodium and glucose

The nurse is caring for a client with a disorder that prevents the pyloric valve from closing properly. For which priority complication should the nurse assess? A. Gastrointestinal bleeding B. Pancreatitis C. Intestinal obstruction D. Jaundice

A. Gastrointestinal bleeding

A family physician is performing client teaching about the influenza virus with each client who has come to the clinic to receive that year's vaccine. Which statement by the client best reflects an accurate understanding of the flu virus? A. I could come down with viral or bacterial pneumonia as a result of a bad flu bug. B. I know my vaccination is especially important since there aren't any drugs that can treat the flu once I get sick with it. C. The emphasis on bundling up, staying warm, and drinking lots of fluids is outdated and actually ineffective D. Like all vaccines, it is ideal id everyone in the population gets immunized against the flu.

A. I could come down with viral or bacterial pneumonia as a result of a bad flu bug.

Which effect of the sympathetic nervous system is most responsible for the development of duodenal ulcers due to anxiety and stress? A. Inhibition of the actions of Brunner glands B. Overstimulation of the oxyntic glands C. Suppression cholecystokinin D. Inflammation of the parotid glands

A. Inhibition of the actions of Brunner glands

Which hospitalized client is most clearly demonstrating the signs and symptoms of liver failure? A. Low hemoglobin levels, low platelet levels, and spider angiomas present B. Blood pressure of 189/103, jaundice, and multiple thromboses C. Sudden onset of confusion, a history of alcohol abuse and low levels of serum AST and ALT D. Ascites, fever, and recent onset of atrial fibrillation

A. Low hemoglobin levels, low platelet levels, and spider angiomas present

A client with uncontrolled hypertension has reviewed the echocardiogram report prior to visiting the health care provider. The client asks, "What does it mean when my ejection fraction is measured as only 30%? I want to know how to get thus back to normal." Which response by the provider is the most accurate? A. Most likely, your low ejection fraction is caused by your uncontrolled high blood pressure B. With the right combination of heart medication and diuretics, your ejection fraction should return back to normal C. This low ejection fraction means you have heart failure and need to go on more medication D. If you are feeling fine without any chest pain, there should be no need to prescribe any further medications.

A. Most likely, your low ejection fraction is caused by your uncontrolled high blood pressure

Which clinical manifestations should the nurse expect to find during physical assessment of a client diagnosed with bronchiectasis? Select all that apply A. Recurrent chest infections B. Production of purulent sputum C. A barrel chest D. Low hemoglobin levels E. Recent surgery

A. Recurrent chest infections B. Production of purulent sputum D. Low hemoglobin levels

The mother of a 7 year old boy who has recently been diagnosed with childhood asthma has come to the education center to learn more about her son's condition. Which teaching point is most justifiable? A. Research has shown that viruses may actually be a factor of childhood asthma. B. The most reliable indicator that your child is having an asthma attack is audible wheezing. C. Steroids that your child can inhale will likely be the first line of defense D. Your son will likely need to limit or avoid exercises and sports

A. Research has shown that viruses may actually be a factor of childhood asthma.

An older adult is admitted with a stroke and has developed pneumonia. While auscultating the right lateral thorax, the nurse hears abnormal breath sounds. Which lobe of the lung is likely effected due to obstruction by thick secretions? A. Right middle lobe B. Right lower lobe C. Right upper lobe D. Left lower lobe

A. Right middle lobe

While explaining the function of the first mucosal layer of the lower two-thirds (2/3) of the esophagus, the pathophysiology instructor mentions which type of functions? Select all that apply. A. Secretion of mucus to lubricate and protect the inner surface of alimentary canal. B. Smooth muscle cells that facilitate movement of contents of the gastrointestinal tract. C. Hold the organs in place and storage for fats. D. Barrier to prevent the entry of pathogenic organisms. E. A cushioning to protect against injury from sports or car accidents.

A. Secretion of mucus to lubricate and protect the inner surface of alimentary canal. D. Barrier to prevent the entry of pathogenic organisms.

Parents have brought their child to the emergency department with abdominal pain. Which clinical manifestations would lead the health care team to suspect the child has appendicitis? Select all that apply. A. Tenderness in right lower quadrant with palpation. B. Rebound tenderness in inguinal areas upon palpation. C. Redness and warmth over right lower quadrant. D. Bloating and flatulence noticeable. E. Urine has the smell of stool with brown coloring.

A. Tenderness in right lower quadrant with palpation. B. Rebound tenderness in inguinal areas upon palpation.

A 6-year-old boy has been brought to the emergency department by his mother complaining his heart rate is "so fast I couldn't even count it." The child was determined to be in atrial flutter via ECG. Which points should underlie an explanation of this event to the mother? A. The child is experiencing a reentry rhythm in his right atrium. B. The resolution of the problem is dependent on spontaneous recovery and is resistant to pacing interventions. C. The child is likely to have a normal ECG apart from the rapid heart rate. D. The boy's atria are experiencing abnormal sympathetic stimulation.

A. The child is experiencing a reentry rhythm in his right atrium.

A nurse is providing care for a client who has been admitted with a newly diagnosed bilateral pleural effusion. Which finding from the nurses's initial assessment of the client is incongruent with the client's diagnosis and would require further investigation? A. The client reports sharp pain exacerbated by deep inspiration B. The client's breath sounds are diminished on auscultation C. Pulse oximetry indicates that the client is hypoxemia D. The client reports dyspnea and increased work of breathing.

A. The client reports sharp pain exacerbated by deep inspiration

The nurse is caring for a client with late stage cirrhosis who is prescribed the beta-blocker propranolol. Which complications of cirrhosis will the nurse expect to be reduced by administration of propranolol? Select all that apply. A. Thrombocytopenia B. Esophageal varices C. Hyperaldosteronism D. Ascites E. Jaundice

A. Thrombocytopenia B. Esophageal varices D. Ascites

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 best captures an aspect of these differences? A. You'll find that in pediatric clients pulmonary edema is more often interstitial rather than alveolar so you often won't hear crackles B. Because of their higher relative blood volume, jugular venous distention is a better assessment technique for suspected heart failure in young clients C. Signs and symptoms in children may sometimes mimic those of shock, with a low blood pressure and high heart rate D. Fever is a sign of heart failure in children that you are unlikely to see in older adults

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

A client has undergone insertion of a drug-eluting stent. Based on clinical trials, which medications when taken in combination, have been found effective to prevent restenosis if taken for up to 1 year after the procedure. Select all that apply A. aspirin B. clopidogrel C. nitroglycerin D. ibuprofen E. vitamin C

A. aspirin B. clopidogrel

A 78 year old male has undergone a total knee replacement. He just doesn't feel like getting out of bed and moving around. After 3 days of staying in bed, he starts to complain of dizziness and lightheadedness. These symptoms are primarily caused by which pathophysiologic principle? Select all that apply A. client is experiencing a reduction in plasma volume. B. peripheral vasoconstriction mechanism has failed C. client is so stressed that he is releasing to many endorphins D. client is still bleeding from the surgical procedure E. client has lost all of his muscle tone

A. client is experiencing a reduction in plasma volume. B. peripheral vasoconstriction mechanism has failed

The nurse practitioner is working in an overnight sleep lab assessing and diagnosing client's with sleep apnea. During this diagnostic procedure, the nurse notes that a client's blood pressure is 162/97. The nurse explains this connection to the client based on which pathophysiologic principle? A. during apneic periods the client experiences hypoxemia, which stimulates chemoreceptors to induce vasoconstriction B. When the client starts to snore, the epiglottis is closed over the trachea C. Specialized cells are located in the back of the threat that signal when the airway is obstructed; this sends signals to the kidney to increase the pulse rate D. When airways are obstructed, the body will retain extracellular fluid so that this fluid can be shifted to intravascular space to increase volume.

A. during apneic periods the client experiences hypoxemia, which stimulates chemoreceptors to induce vasoconstriction

All of the following interventions are ordered STAT for a client stung by a bee who is experiencing severe respiratory distress and faintness. Which priority intervention will the nurse administer first? A. epinephrine B. normal saline infusion C. Dexamethasone D. Diphenhydramine

A. epinephrine

The nurse notes a client's bilirubin level is 2.5 mg/dL (42.8 μmol/L). Which assessment is most relevant for the nurse to perform based on these results? The nurse should assess the client's: A. eyes. B. oral mucosa. C. level of orientation. D. abdominal girth.

A. eyes.

A client who has been on a high protein diet comes to the ER with respiratory symptoms. Upon analysis of arterial blood gases, the client is diagnosed with hypercapnia. Which ABG results confirm this diagnosis? Select all that apply A. pH 7.31 B. PO2 97% C. PCO2 58 mm Hg D. Serum HCO3 33 mEq/L E. Serum K+ 3.6 mmol/L

A. pH 7.31 C. PCO2 58 mm Hg D. Serum HCO3 33 mEq/L

The nurse is caring for a client who is being treated for pneumonia. The nurse suspects the client has developed pleuritis. Which assessment findings support the nurse's suspicion of pleuritis. Select all that apply: A. shoulder pain B. bilateral chest wall pain C. Pain when deep breathing and coughing D. Purulent sputum E. Unequal chest expansion on inspiration

A. shoulder pain C. Pain when deep breathing and coughing E. Unequal chest expansion on inspiration

Which statement describes phase 4 of the action potential of cells in the sinoatrial (SA) node? A. slow depolarization occurs when Na^ + is transported out of the cell and K moves back in, resulting in resting membrane potential. B. The cells are capable of responding to a greater-than-normal stimulus before the resting membrane potential is reached. C. The fast sodium channels in the cellular membranes close , causing an abrupt decrease in intracellular positivity D. Potassium permeability is allowing the cell membrane to remain depolarized and the Ca^ ++ channel opens , moving Ca^ ++ back into the cell .

A. slow depolarization occurs when Na^ + is transported out of the cell and K moves back in, resulting in resting membrane potential.

An IV drug abuser walks into the ED telling the nurse that, "they are sick." They look 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 large vegetation growing on their mitral valve. The patient is admitted to ICU. The nurse will be assessing this patient for which possible life-threatening complications? A. systemic emboli, especially to the brain B. Petechial hemorrhages under the skin and nail beds C. GI upset from the massive amount of antibiotics required to kill bacteria D. pancreas enlargement due to increased need for insulin secretion

A. systemic emboli, especially to the brain

A physician is explaining to a group of medical students the concept of Virchow's triad as it applies to venous thrombosis. Which clinical observation of a 50 year old male client is most likely unrelated to a component of Virchow's triad? A. the man has decreased cardiac output and an ejection fraction of 30% B. The man's prothrombin time and international normalized ratio (INR) are both low. C. The man has a previous history of a dissecting aneurysm D. There is bilateral, brown pigmentation of his lower legs

A. the man has decreased cardiac output and an ejection fraction of 30%

The nurse is prioritizing clients based on the risk for falls. Which client would be at greatest risk for sudden falls and related injury? The client: A. with uncontrolled sick sinus syndrome. B. with poorly controlled type 1 diabetes. C. who is immobile due to recent stroke. D. with atrial fibrillation and on anticoagulants.

A. with uncontrolled sick sinus syndrome.

Which client should the nurse be assessing for long QT syndrome? A. 95-year-old Alzheimer client who is having periods of apnea. B. 32-year-old male admitted for cocaine overdose with long history of illicit drug abuse C. 56-year-old female admitted for total hysterectomy due to excessive bleeding and clotting D. 68-year-old male who was in a car accident with sterna bruising and fractured femur

B. 32-year-old male admitted for cocaine overdose with long history of illicit drug abuse

When advising a morbidly obese client about the benefits of weight reduction, which statement would be most accurate to share? A. All you need to do is stop drinking sodas and sugary drinks B. A 10 pound loss of weight can produce a decrease in blood pressure C. An increased waist-to-hip ration can lead to too much pressure on the liver and intestines D. If your leptin hormone level is too low, you are at increased risk for developing high BP

B. A 10 pound loss of weight can produce a decrease in blood pressure

Which client is most clearly displaying the signs and symptoms of irritable bowel disease (IBD)? A. A 32-year-old mother who reports intermittent abdominal pain that is worse during her menstrual period. B. A 51-year-old male who states that his stomach pain is in his lower abdomen, "comes and goes" and "feels more like a cramp than a dull ache." C. A 44-year-old man who works the evening shift at a factory and who states that his lower abdominal pain is much worse at night than during the day. D. A 24-year-old man who has a stressful job but whose diarrhea and cramping does not worsen during periods of high stress.

B. A 51-year-old male who states that his stomach pain is in his lower abdomen, "comes and goes" and "feels more like a cramp than a dull ache."

A number of clients on an acute cardiac care unit of a hospital have diagnoses of impaired cardiac conduction. Which client is most deserving of immediate medical attention? A. A 46-year-old man whose cardiac telemetry shows him to be in ventricular tachycardia B. A 69-year-old woman who has entered ventricular fibrillation C. A 60-year-old man with premature ventricular contractions (PVC) and a history of atrial fibrillation D. A 60-year-old woman who has just been diagnosed with a first-degree AV block

B. A 69-year-old woman who has entered ventricular fibrillation

Which phenomenon is most likely occurring during a child's alveolar stage of lung development? A. Terminal alveolar sacs are developing and surfactant productions is beginning B. A single-capillary network exists and the lungs are capable of respiration C. The conducting airways are formed, but respiration is not yet possible D. Primitive alveoli are formed and the bronchi and bronchioles become much larger.

B. A single-capillary network exists and the lungs are capable of respiration

Which client on the nurse's team will be given priority for cardiac monitoring based on medical history? A. Postoperative client who has a history of diabetes for the last 10 years B. Adolescent client resuscitated following drowning in a swimming pool that required CPR at the scene C. Adult client who had a pacemaker implanted 5 years ago admitted with chronic obstructive pulmonary disorder (COPD) D. Older adult client admitted with pneumonia for a few days of IV antibiotics

B. Adolescent client resuscitated following drowning in a swimming pool that required CPR at the scene

A 43-year-old male client has presented to the emergency department with vomiting that he claims is of a sudden onset. The client also states that the emesis has often contained frank blood in the hours prior to admission. His vital signs are stable with temperature 98.3°F (36.8°C), pulse 88, BP 140/87, and respiratory rate 18. Which potential contributing factor would the health care team suspect first? A. Overuse of antacids B. Alcohol consumption C. Staphylococcal enterotoxins D. Effects of Helicobacter pylori

B. Alcohol consumption

A medical student is working with a 61-year-old male client in the hospital who has presented with a new onset of atrial fibrillation. Which course of treatment will the student most likely expect the attending physician to initiate? A. Immediate cardioversion followed by surgery to correct the atrial defect B. Anticoagulants and beta-blockers to control rate C. Antihypertensives and constant cardiac monitoring in a high acuity unit D. Diuretics, total bed rest, and cardioversion if necessary

B. Anticoagulants and beta-blockers to control rate

An 81 year old female client of a long term care facility has a history of congestive heart failure. The nurse practitioner caring for the client has positioned her sitting up at an angle in bed and is observing her jugular venous distention. Why is jugular venous distention a useful indicator for the assessment of the client's condition? A. Increased cardiac demand causes engorgement of systemic blood vessels, of which the jugular vein is one of the largest. B. Blood backs up into the jugular vein because there are no valves at the point of entry into the heart. C. Peripheral dilation is associated with decreased stroke volume and ejection fraction. D. Heart valves are not capable of preventing backflow in cases of atrial congestion

B. Blood backs up into the jugular vein because there are no valves at the point of entry into the heart.

A client is experiencing impaired circulation secondary to increased systemic arterial pressure. Which statement is the most relevant phenomenon? A. Increased preload due to vascular resistance B. High afterload because of back pressure against the left ventricle C. Impaired contractility due to aortic pressure resistance D. Systolic impairment because of arterial stenosis

B. High afterload because of back pressure against the left ventricle

A pneumonia that occurs 48 hours or more after admission to the hospital is considered: A. Community acquired pneumonia B. Hospital acquired pneumonia C. Viral pneumonia D. Immunocompromised pneumonia

B. Hospital acquired pneumonia

As a consequence of long-standing lung disease, a client is in a chronic state of hypoxia. Which phenomena would the client's care team be most justified in anticipating? Select all that apply A. Metabolic alkalosis B. Increased erythropoietin production C. Pulmonary vasodilation D. Hyperventilation E. Personality changes

B. Increased erythropoietin production D. Hyperventilation E. Personality changes

A male, lifetime smoker has died as a result of chronic obstructive pulmonary disease. Which phenomenon regarding his alveoli would his care team have expected in the weeks prior to his death? A. Proliferation of natural killer cells in alveolar lumen B. Large numbers of alveolar macrophages in septal connective tissue C. The presence of tubercles in the inter alveolar spaces D. Compensatory regeneration of Type 1 alveolar cells

B. Large numbers of alveolar macrophages in septal connective tissue

The nurse has completed an automated blood pressure and pulse reading on a client with persistent atrial fibrillation. The client's baseline values are blood pressure 130/85 mm Hg and heart rate of 80 bpm and irregular. The current result is blood pressure is 98/47 mm Hg, the heart rate is 77 bpm, and the client denies feeling differently. What is the nurse's priority action? A. Have the client lie flat and with the legs elevated (modified Trendelenburg position). B. Perform a manual blood pressure and apical heart rate reading. C. Analyze the client's most recent electrocardiogram. D. Hold all antihypertensive medications and notify the health care provider.

B. Perform a manual blood pressure and apical heart rate reading.

The nurse is hearing diminished breath sounds and a "grating" sound during respirations. This is consistent with excess collection of fluid in the pleural cavity. The medical term for this is: A. Pleurisy B. Pleural effusion C. Pneumothorax D. Poor lung compliance

B. Pleural effusion

1. A physician has ordered the measurement of a cardiac client's electrolyte levels as part of the client's morning blood work. Which statement best captures the importance of potassium in the normal electrical function of the client's heart? A. Potassium catalyzes the metabolism of ATP, producing the gradient that results in electrical stimulation . B. Potassium is central to establishing and maintaining the resting membrane potential of cardiac muscle cells. C. The impermeability of cardiac cell membranes to potassium allows for action potentials achieved by the flow of sodium ions. D. The reciprocal movement of one potassium ion for one sodium ion across the cell membrane results in the production of an action potential .

B. Potassium is central to establishing and maintaining the resting membrane potential of cardiac muscle cells.

Reviewing pathology for an exam on pulmonary vasculature, the nursing student states that blood enters the right side of the heart via vena cava's, then to the right atrium, right ventricle, and then which vessel carries the deoxygenated blood into the pulmonary system? A. Pulmonary capillaries B. Pulmonary Artery C. Pulmonary Vein D. Ductus arteriosus

B. Pulmonary Artery

A client in the intensive care unit has a blood pressure of 87/39 and has warm, flushed skin accompanying his sudden decline in level of consciousness. The client also has arterial and venous dilatation and a decrease in systemic vascular resistance. What is this client's most likely diagnosis? A. Hypovolemic shock B. Septic shock C. Neurogenic shock D. Obstructive shock

B. Septic shock

When ablation therapy is added to an electrophysiologic test, the nurse should be assessing the client for which complication of ablation that may occur postprocedure? A. Complaints of nausea and spitting up bile-looking secretions along with stomach cramps. B. Sudden onset of dyspnea, tachypnea, and chest pain that is worsened by breathing. C. Bleeding from the nose that requires packing, excessive swallowing of mucus, and coughing. D. Sudden decrease in level of consciousness accompanied by fixed pupils

B. Sudden onset of dyspnea, tachypnea, and chest pain that is worsened by breathing.

An ECG technician is placing leads on a client who has presented to the emergency department with a sudden onset of chest pain. The technician would recognize which fact about the placement of leads and the achievement of a clinically accurate ECG? A. The electrical potential recorded by a lead on an extremity will vary significantly depending on where the lead is placed on the extremity B. The chest leads measure electrical activity on the horizontal plane, while limb leads measure it on the vertical plane. C. Limb leads measure the electrical activity of the heart indirectly through the activity of adjacent skeletal muscle. D. A total of 12 chest leads is necessary to attain the most accurate ECG.

B. The chest leads measure electrical activity on the horizontal plane, while limb leads measure it on the vertical plane.

A 51 year old female client who is 2 days post-op in a surgical unit of a hospital is at risk of developing atelectasis as a result go being largely immobile. Which teaching point by her nurse is most appropriate? A. Being in bed increases the risk of fluid accumulating between you lungs and their lining, so it is important for you to change positions often. B. You should breathe deeply and cough to help your lunged expand as much as possible while you're in bed. C. Make sure that you stay hydrated and walk as soon as possible to avoid having to insert a chest tube. D. I'll prescribe bronchodilator medications that will help open ip your airways and allow more oxygen in.

B. You should breathe deeply and cough to help your lunged expand as much as possible while you're in bed.

The nurse is caring for a client with angina. If wanting to reduce the Frank-Starling effect on myocardial oxygen consumption, what type of medication would the nurse expect to be prescribed? A. a positive inotrope B. a venous vasodilator C. an arterial vasodilator D. an anticoagulant

B. a venous vasodilator

The nurse is caring for clients with chronic respiratory disorders. For which client with cyanosis should the nurse intervene first? The client with cyanosis and: A. a diagnosis of chronic obstructive pulmonary disease B. anemia of chronic disease and a hemoglobin of 8.7 C. polycythemia and a hemoglobin of 16.8 D. a blood pressure of 155/95 mmHg

B. anemia of chronic disease and a hemoglobin of 8.7

A 77 yer old client with a history of coronary artery disease and heart failure has arrived in the ED with a rapid heart rate and feeling of "impending doom". Based on pathophysiologic principles, the nurse knows the rapid heart rate could: A. decrease renal perfusion and result in development of ascites B. be a result of catecholamines released from SNS, which could increase the myocardial oxygen demand C. desensitize the alpha-adrenergic receptors leading to increase in norepinephrine levels D. prolong the electrical firing from the SA node resulting in development of a heart block

B. be a result of catecholamines released from SNS, which could increase the myocardial oxygen demand

An older adult client arrives to the health care provider's office complaining of a "sore" that won't heal on the lower leg. Upon assessment, the nurse finds thin, shiny, bluish brown pigmented desquamative skin. It is located medially over the lower leg. The nurse will educate the client that the usual treatment is: A. hydrotherapy treatments to facilitate improvement in circulation B. compression therapy to help facilitate blood flow back to the vena cava. C. initiation of warfarin therapy to maintain an INR of 2-3 above norm. D. long term antibiotic therapy to facilitate healing of the wound

B. compression therapy to help facilitate blood flow back to the vena cava.

A middle-aged man walks into the emergency department reporting chest pain radiating to the neck, shortness of breath, and nausea. His heart rate is 120 and BP is 94/60. The ED physician recognizes the client is having an acute MI with decreased cardiac output. The nurse identifies the nausea to be in response to: A. the client doesn't have a very high pain tolerance. B. hypoxia exerting a direct effect on the chemoreceptor trigger zone. C. the client hasn't digested his meal completely. D. fear of having to make major lifestyle changes.

B. hypoxia exerting a direct effect on the chemoreceptor trigger zone.

A client has recently been diagnosed with H. pylori gastritis. The nurse knows that this form of gastritis is usually treated with a combination of an antibiotic and: A. anti-anxiety medications. B. proton pump inhibitors. C. lactulose, to reduce the blood ammonia levels. D. calcium carbonate, an antacid.

B. proton pump inhibitors.

Following a history of gastric pain and an endoscopy, a client has been diagnosed with a duodenal peptic ulcer. Which teaching point should his caregiver provide? A. "While your diet most certainly contributed to this problem, the good news is that changing your diet can help solve it." B. "Ulcers like yours do not penetrate all layers of the stomach or duodenum so you don't have to worry about losing too much blood." C. "Your family history, your smoking history, and NSAID use may all have contributed to this problem." D. "While there aren't really any effective medications for these ulcers, changes in lifestyle can keep them well controlled."

C. "Your family history, your smoking history, and NSAID use may all have contributed to this problem."

Assuming that they have not responded to drug therapy, which client is likely to be the best candidate for surgical cardiac ablation? A. A 62-year-old woman with peripheral vascular disease who has experienced multiple episodes of torsades des pointes B. A 75-year-old man with diabetes but no previous heart disease that suddenly develops syncope due to sick sinus syndrome C. A 46-year-old man with unstable angina and a history of myocardial infarction who is found to have long Q-T syndrome and episodes of frequent ventricular dysrhythmias

C. A 46-year-old man with unstable angina and a history of myocardial infarction who is found to have long Q-T syndrome and episodes of frequent ventricular dysrhythmias

In which of the following hospital clients would the care team most realistically anticipate finding normal cholesterol levels? A. A 44 year old male admitted for hyperglycemia and with a history of diabetic neuropathy B. A 77 year old female admitted for rheumatoid arthritis exacerbation who is receiving hormone replacement therapy and has a history of hypothyroidism C. A 51 year old male with a diagnosis of hemorrhagic stroke and consequent unilateral weakness D. A morbidly obese 51 year old female who is taking diuretics and a beta-blocker to treat her hypertension

C. A 51 year old male with a diagnosis of hemorrhagic stroke and consequent unilateral weakness

A health educator is performing a health promotion workshop with the staff of a large, urban homeless shelter, and a component of the teaching centers around tuberculosis. One of the staff members comments "Anyone who has had contact with tuberculosis in the past can give it to any of the other residents of the shelter, even if they didn't get sick themselves" How could the educator best reskins to this comment. A. Many people do manage to fight off the infection, but you're right- they can still spread it by coughing or sneezing B. If someone has been previously exposed to tuberculosis, they are particularly infectious because they are often unaware of the disease C. Actually, people who have the latent form of the disease won't be sick and can't spread it either. D. There isn't any real risk of them spreading it, but we would like to vaccinate everyone who's had any contact with it in the past.

C. Actually, people who have the latent form of the disease won't be sick and can't spread it either.

A client with pancreatic cancer is admitted for portal hypertension and is symptomatic with ascites. Following paracentesis and removal of 7.5 L of ascitic fluid, the nurse should anticipate that the physician will order which medication to assist in maintaining an effective circulating fluid volume? A. Bumetanide B. Furosemide C. Albumin (Human) 5%. D. Epoetin alfa

C. Albumin (Human) 5%.

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

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

A client is diagnosed with a stroke that affects the left hemisphere of the brain, and the health care provider has prescribed testing to assess for damage to the glottis. Which action should the nurse take prior to allowing the client to receive food/beverages from the cafeteria? A. Monitor for impaired memory and judgement B. Assess for attention deficits which will determine whether the client can feed oneself without assistance C. Assess ability to swallow and check breath sounds for signs of aspiration pneumonia D. Identify whether the client can make reasonable decisions versus poor reasoning skills.

C. Assess ability to swallow and check breath sounds for signs of aspiration pneumonia

In the early morning, a parent brings the 5 year old child to the emergency room. The child is wheezing, short of breath, and has a dry cough. The parent states that the child has always been very healthy. The child went to bed with only a slight cold and a runny nose but woke up coughing shortly after 4 am. The symptoms worsened so dramatically that parent brought the child to the hospital. The care team would most likely suspect that the child has: A. respiratory syncytial virus B. Influenza C. Asthma D. Pneumonia

C. Asthma

A 70 year old male client presents to the emergency department reporting pain in his calf that is exacerbated when he walks. His pedal and popliteal pulses are faintly palpable and his leg distal to the pain is noticeably reddened. The nurse knows that the client is likely experiencing which medical diagnosis/possible treatment plan listed below? A. acute arterial occlusion that will be treated with angioplasty B. Raynaud disease that will require anti-platelet medications C. Atherosclerotic occlusive disease necessitating thrombolytic therapy D. Giant cell temporal arteritis that will be treated with corticosteroids

C. Atherosclerotic occlusive disease necessitating thrombolytic therapy

The nurse caring for a client with protal hypertension and subsequent development of esophageal varices will likely receive a prescription for which drug class to assist with decreasing portal pressure? A. Angiotensin-converting enzyme (ACE) inbitibors B. Sympathomimetic agents C. Beta-adrenergic blocking agent D. Inotropic agent

C. Beta-adrenergic blocking agent

The nurse is caring for a client in intensive care receiving mechanical ventilation and intravenous insulin infusion. The nurse notes sudden onset hypotension, tachycardia, and jugular vein distention. What should the nurse do first? A. Check the client's current blood glucose level. B. Retrieve the client's most recent arterial blood gas result. C. Check the tidal volume setting on the ventilator D. Assess the client's fluid volume balance

C. Check the tidal volume setting on the ventilator

Following a 14-day course of broad-spectrum antibiotics for the treatment of sepsis, a client develops watery diarrhea attributed to the elimination of normal intestinal flora. What other phenomena are most likely accompanying the low levels of normal flora? A. Decreased mineral and nutrient absorption; decreased carbohydrate metabolism B. Decreased pH of the stomach; increased pH of the lower gastrointestinal tract C. Decreased fermentation of undigestible dietary residue; decreased vitamin absorption D. Proliferation of vitamin K; lower gastrointestinal bleeding

C. Decreased fermentation of undigestible dietary residue; decreased vitamin absorption

Which clinical finding would be most closely associated with a client who has interstitial lung disease in comparison to chronic obstructive pulmonary disease? A. Audible wheezing on expiration B. Reduced expiratory flow rates C. Decreased tidal volume D. Normal forced expiratory volume

C. Decreased tidal volume

A 30 year old woman presents at a hospital after fainting at a memorial service and she is diagnosed as being in neurogenic shock. Which signs/symptoms is she most likely to display? A. faster than normal heart rate B. Pain C. Dry and warm skin D. Increased thirst

C. Dry and warm skin

A 3 year old child with right-sided heart failure has been admitted for worsening of their condition. Which assessment would be considered one of the earliest signs of systemic venous congestion in this toddler? A. breathlessness with activity B. excessive crying C. Enlargement of liver D. Increased urine output

C. Enlargement of liver

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 health problem would the care team first suspect? A. Rotavirus infection B. Appendicitis C. Esophagitis from gastrointestinal reflux D. Hirschsprung disease

C. Esophagitis from gastrointestinal reflux

A nurse on a respiratory unit of a hospital is providing care for a client with end-stage lunch disease. Consequently, measurement of the client's arterial blood gases indicates increased PCO2. Which associated consequence would the nurse anticipate? A. A shift to the left pf the oxygen-hemoglobin dissociation curve B. Lower than normal production of HCO3 C. Higher than normal production of H+ D. An absence of carbaminohemoglobin

C. Higher than normal production of H+

A nurse practitioner is providing care for a male client with a longstanding hiatal hernia. Which statement most accurately captures an aspect of the pathophysiology of hiatal hernias? A. Paraesophageal hiatal hernias are common and are normally not treated if the client is asymptomatic. B. The root causes of hiatal hernias are normally treatable with medication. C. If esophageal acid clearance is impaired, esophagitis can result. D. An incompetent pyloric sphincter and high fat diet are commonly implicated in the development of hiatal hernias.

C. If esophageal acid clearance is impaired, esophagitis can result.

A 22 year old male is experiencing hypovolemic shock following a fight in which his carotid artery was cut with a broken bottle. What immediate treatments are most likely to benefit the man? A. resolution of compensatory pulmonary edema and heart dysrhythmias B. Infusion of vasodilators to foster perfusion and inotropes to improve heart contractility C. Infusion of normal saline or Ringer's lactate to maintain the vascular space. D. Administration of oxygen and epinephrine to promote perfusion

C. Infusion of normal saline or Ringer's lactate to maintain the vascular space.

A 66 year old male presents to the emergency room accompanied by his wife who claims that he has been acting confused. The man is reporting a sudden onset of severe weakness and malaise and has a dry cough and diarrhea. His temp is 102.8 F and his blood work indicates his sodium level at 126 mEq/L. Based on this assessment, the nurse suspects the client has: A. bronchopneumonia B. Mycoplasma pneumonia C. Legionella pneumonia D. Pneumococcal pneumonia

C. Legionella pneumonia

A nurse is caring for four clients with the diagnosis of atrial fibrillation. Which client will likely require cardioversion related to complications? A. Client admitted with blood clots in the lungs from undiagosed atrial fibrillation B. Client experiencing bleeding related to anticoagulants prescribed for the atrial fibrillation C. Newly diagnosed client with atrial fibrillation and has developed pulmonary edema D. Client who fainted because of a very low pulse rate due to an antiarrhythmic medication

C. Newly diagnosed client with atrial fibrillation and has developed pulmonary edema

A child with rhino-sinusitis should be monitored for complications. Which assessment finding would alert the nurse that a complication is developing? A. Purulent nasal discharge B. Temperature of 100.8 F C. Periorbital edema D. Reports of headache

C. Periorbital edema

A short, non-smoking 44 year old male presents to the emergency room with left-sided chest pain and a cough. He states the pain started abruptly and worsens with deep breathing and coughing. He denies recent injury. Assessment includes shallow respirations with a rate of 36, normal breath sounds, no cyanosis. Which condition is most likely causing his symptoms? A. Myocardial Infarction B. Spontaneous pneumothorax C. Pleuritis related to infection D. Obstructive atelectasis

C. Pleuritis related to infection

During a sleep study in the laboratory, the health care provider notices one client has a prolonged period of asystole. Which term will the nurse use to describe this event in the documentation? A. Bradycardia-tachycardia syndrome B. Junctional rhythm C. Sinus arrest D. Long QT syndrome

C. Sinus arrest

A 74 year old man is being assessed by a nurse as part of a weekly basic health assessment at the long term care facility where he resides. His blood pressure at the time is 148/97, with a consequent pulse pressure of 51. The nurse would recognized that which of the following is the most significant determinant of the resident's pulse pressure? A. blood volume, resistance, and flow B. the cardiac reserve, or possible increase in cardiac output over normal resting level C. The amount of blood that his heart ejects from the left ventricle during each beat D. the relationship between total blood volume and resting heart rate

C. The amount of blood that his heart ejects from the left ventricle during each beat

As part of their orientation to a cardiac care unit, a group of recent nursing graduates is receiving a refresher in cardiac physiology from the unit educator. Which of the following teaching points best captures a component of cardiac function? A. Efficient heart function requires that the ventricles not retain any blood at the end of the cardiac cycle. B. Recall that the heart sounds that we listen to as part of our assessments are the sounds of the myocardium contracting. C. The diastolic phase is characterized by relaxation of ventricles and their filling with blood. D. Aortic pressure will exceed ventricular pressure during systole.

C. The diastolic phase is characterized by relaxation of ventricles and their filling with blood.

The cardiologist just informed a client that he has a reentry circuit in the electrical conduction system in his heart . This dysrhythmia is called Wolff Parkinson -White (WPW) syndrome. After the physician has left the room , the client asks the nurse to explain this Which statement most accurately describes what is happening? A. This means that the SA node (which is the beginning of your heart's electrical system) has been damaged and is no longer functioning normal B. "You must have a large clot in one of your arteries that supply oxygenated blood to the special conduction cells in your heart. C. There is an extra , abnormal electrical pathway in the heart that leads to impulses traveling around the heart very quickly , in a circular pattern , causing the heart to beat too fast D. "For some reason , your electrical system is not on full charge so they will have to put in new leads and a pacemaker to make it work better ."

C. There is an extra , abnormal electrical pathway in the heart that leads to impulses traveling around the heart very quickly , in a circular pattern , causing the heart to beat too fast

When educating a college student who lives in a crowded apartment and was recently diagnosed with tuberculosis, the school nurse will emphasize which treatment plan? A. Once your fever goes away, you can stop taking the streptomycin injection. B. If isoniazid makes your nauseous, we can substitute something milder C. To destroy this bacterium, you must strictly adhere to a long-term drug regimen of several medications D. You will have to wear a N95 mask while on campus at all times.

C. To destroy this bacterium, you must strictly adhere to a long-term drug regimen of several medications

The nurse walks into a room and finds the client forcefully expelling stomach contents into a wash basin. When documenting this occurrence, the nurse will use the term: A. Nauseous B. Retching C. Vomiting D. Expatriate

C. Vomiting

In the ICU, the nurse hears an emergency cardiac monitor go off. The nurse looks at the telemetry and notices the client has gone into ventricular tachycardia. The nurse will likely assess for signs/symptoms of: A. Development of hypertension with BP 190/98 B. oxygen deprivation with O2 saturation decreasing to about 90% C. decreasing cardiac output due to less ventricular filling time D. increasing cardiac index by correlating the volume of blood pumped by the heart with an individuals body surface area

C. decreasing cardiac output due to less ventricular filling time

A nurse will be providing care for a female client who has a diagnosis of heart failure that has bee characterized as being primarily right-sided. Which statement best described the presentation that the nurse should anticipate? The client: A. has a distended bladder, facial edema, and difficulty breathing during night time hours B. Complains of dyspnea and has adventitious breath sounds on auscultation C. has pitting edema to the ankles and feet bilaterally, decreased activity tolerance, and occasional upper right quadrant pain D. has cyanotic lips and extremities, low urine output, and low blood pressure

C. has pitting edema to the ankles and feet bilaterally, decreased activity tolerance, and occasional upper right quadrant pain

A 51-year-old male professional is in the habit of consuming 6 to 8 rum and Cokes each evening after work. He assures the nurse practitioner who is performing his regular physical exam that his drinking is under control and does not have negative implications for his work or family life. How could the nurse best respond to the client's statement? A. "You are more than likely inflicting damage on your liver, but this damage would cease as soon as you quit drinking." B. "That may be the case, but you are still creating a high risk of hepatitis A or B or liver cancer." C. "In spite of that, the amount of alcohol you are drinking is likely to result first in cirrhosis and, if you continue, in hepatitis or fatty liver changes." D. "When your body has to regularly break down that much alcohol, your blood and the functional cells in your liver accumulate a lot of potentially damaging toxic by-products."

D. "When your body has to regularly break down that much alcohol, your blood and the functional cells in your liver accumulate a lot of potentially damaging toxic by-products."

A 63-year-old male client has been diagnosed with a bundle branch block. How will this client's care team most likely expect his condition to be expressed diagnostically? A. His AV node will be performing the primary pacemaker role due to inadequacy of the SA node. B. His ECG will show a flattened P wave as a result of impaired atrial depolarization. C. Conduction from the ventricle to the bundle branches is compromised by inadequate conduction. D. His ECG will show an inordinately wide QRS complex because impulses are bypassing normal conduction tissue.

D. His ECG will show an inordinately wide QRS complex because impulses are bypassing normal conduction tissue.

While rock climbing, a 22 year-old male has endured a severe head injury. Which of the following statements best captures expected clinical manifestations and treatments for his immediate condition? A. Oxygen therapy is likely to decrease his respiratory drive and produce an increase in PCO2. B. Cheyne-Stokes breathing is likely but will respond to bronchodilators C. The client is unlikely to respond to supplementary oxygen therapy due to impaired diffusion. D. Hypoventilation may exist, resulting in increased PCO2 and hypoxemia that may require mechanical ventilation.

D. Hypoventilation may exist, resulting in increased PCO2 and hypoxemia that may require mechanical ventilation.

A young woman has been diagnosed by her family physician with primary Raynaud disease. The woman is distraught stating I've always been healthy and I can't believe I have a disease now. What would be her physicians most appropriate response? A. This likely won't have a huge effect on your quality of life and I'll prescribe anti-clotting drugs to prevent attacks B. I'll teach you some strategies to minimize its effect on your life, and minor surgery to open up your blood vessels will help too C. You need to make sure you never start smoking, and most of the symptoms can be alleviated by regular physical activity D. If you make sure to keep yourself warm, it will have a fairly minimal effect: I'll also give you pills to enhance your circulation

D. If you make sure to keep yourself warm, it will have a fairly minimal effect: I'll also give you pills to enhance your circulation

A resident of a long-term care facility has contracted Clostridium difficile with frequent diarrhea and hyperactive bowel sounds. What process in the small intestine is most likely accompanying the current status? A. Pathogenic microorganisms are causing dilation of the small intestine, increasing motility. B. Segmentation waves have become more frequent as a result of the infection. C. Intestinal stasis brought on by infection is preventing the small intestine from sufficiently slowing the rate of motility. D. Inflammation is accompanied by an increase in peristaltic movements of the small intestine.

D. Inflammation is accompanied by an increase in peristaltic movements of the small intestine.

Around three weeks after razing an old chicken house, a 71-year-old retired farmer has developed a fever, nausea and vomiting. After ruling out more common health problems, his care provider eventually made a diagnosis of histoplasmosis. Which of the following processes is most likely taking place? A. Toxin production by Histoplasma capsulatum is triggering an immune response. B. Antibody production against the offending fungi is delayed by the client's age and the virulence of the organism C. Spore inhalation initiates an autoimmune response that produces the associated symptoms D. Macrophages are able to remove the offending fungi from the bloodstream but can't destroy them.

D. Macrophages are able to remove the offending fungi from the bloodstream but can't destroy them.

A 20-year-old woman has visited her family physician due to occasional bouts of bloody diarrhea over the past several weeks, a phenomenon that she experienced 2 years prior as well. Her physician has diagnosed her with ulcerative colitis based on her history and visualization of the affected region by colonoscopy and sigmoidoscopy. Which pathophysiologic phenomenon is most likely to underlie the client's health problem? A. Fissures and crevices developing in the mucosa that are seen as a characteristic "cobblestone" appearance. B. Erosion of the endothelial lining of the distal small intestine by a combination of genetic, autoimmune, and environmental factors. C. Compromise of the mucosal layer of the large intestinal surface by the effects of H. pylori. D. Mucosal hemorrhages that have developed into crypt abscesses, which have in turn necrotized and ulcerated.

D. Mucosal hemorrhages that have developed into crypt abscesses, which have in turn necrotized and ulcerated.

After several months of persistent heartburn, a 57-year-old female client has been diagnosed with gastroesophageal reflux disease (GERD). Which treatment regimen is likely to best address the woman's health problem? A. Surgical correction of the incompetent pylorus. B. Antacids; avoiding positions that exacerbate reflux; a soft-textured diet C. Weight loss and administration of calcium channel blocking medications. D. Proton pump inhibitors; avoiding large meals; remaining upright after meals

D. Proton pump inhibitors; avoiding large meals; remaining upright after meals

The nurse is caring for the client with extrahepatic cholestasis. Which symptom does the nurse anticipate uncovering during the history and assessment? A. Complaints of lower flank pain with consequences of impaired fat metabolism. B. Anorexia with consequences of impaired drug metabolism and blood filtration. C. Skin xanthomas (focal accumulations of cholesterol) with consequences of increased risk of bleeding due to deficient clotting factors. D. Pruritus with consequences of deficient levels of fat-soluble vitamins.

D. Pruritus with consequences of deficient levels of fat-soluble vitamins.

A client arrives reporting feeling "faint and dizzy" when standing and on telemetry the client's heart rate is 25 beats/min. On electrocardiogram, the rate is fairly consistent and lacks the normal "P" wave and the QRS is wider than normal. This client's heart rhythm is being controlled by which cardiac structure? A. Sinoatrial (SA) node B. Atrioventricular (AV)nnode C. Bundle of His D. Purkinje system

D. Purkinje system

A physiotherapist is measuring the lying, sitting, and standing blood pressure of a client who has been admitted to the hospital following a syncopal episode and recent falls. Which fact about the client best relates to these health problems? A. The client is male and has a history of hypertension B. The client's cardiac ejection fraction was 40% during his las echocardiogram C. The client has a history of acute and chronic renal failure D. The client is 89 years old and takes a diuretic medication for his congestive heart failure

D. The client is 89 years old and takes a diuretic medication for his congestive heart failure

A number of clients have presented to the emergency department in the last 32 hours with reports that are primarily indicative of myocardial infraction. Which client is least likely to have an ST segement myocardial infarction (STEMI)? A. a 70 year old woman who is reporting shortness of breath and vague chest discomfort B. a 66 year old man who has been presented with fatigue, nausea, and vomiting, and cool moist skin C. a 43 year old man who woke up with substernal pain that is radiating to his neck and jaw D. a 71 year old man who has moist skin, fever, and chest pain that is excruciating when he moves but relieved when at rest.

D. a 71 year old man who has moist skin, fever, and chest pain that is excruciating when he moves but relieved when at rest.

Mr. V. has been admitted for exacerbation of his chronic heart failure (HF). When the nurse walks into his room, he is sitting on the edge of the bed, gasping for air, and his lips are dusty blue. Vital signs reveal heart rate 112, respiratory rate 36, and pulse oximeter reading of 81%. He starts coughing up frothy pink sputum. The priority intervention is: A. have medical supply department bring up suction equipment B. apply oxygen via nasal cannula at 3 pm C. page respiratory therapy to come give him a breathing treatment D. call for emergency assistance utilizing hospital protocol

D. call for emergency assistance utilizing hospital protocol