Exam Review
- Which assessment finding alerts the nurse to the possibility of decreased cardiac output in the patient who suddenly develops atrial fibrillation?A)Increase capillary refill time.B)Rumbling heart murmur.C)Intermittent claudication.D)Jugular venous distension.
- A patient has been diagnosed with coronary artery disease (CAD) and was told she has a small plaque in the lumen of a coronary artery. The patient is placed on an EKG monitor during her chest pain episode and develops these vital signs: BP 110/70, HR 120, RR 18. What physiologic mechanism is most likely responsible for the tachycardia?A)Decrease in circulating epinephrine.B)Sympathetic nervous system (SNS) activity.C)Increase in circulating acetylcholine.D)Parasympathetic nervous system (PNS) activity.
- A woman presents to a clinic with JVD (jugular venous distension), liver congestion, ascites, and ankle edema. Upon auscultation of her heart, the RN notes a murmur. The etiologies that would best account for all aspects of this patient picture areA)aortic atherosclerosis & mitral insufficiency.B)aortic valve stenosis & left heart failure.C)bronchogenic cancer & diaphoresis.D)pulmonic valve stenosis & right heart failure.
- A nurse is examining a patient who reports burning on urination and a low-grade fever. On physical examination, the nurse notes constant right-sided costovertebral tenderness. Based on this presentation, what is most likely the cause of these signs and symptoms (S&S)?A)Prostate cancer.B)Ureteral lithiasis.C)Primary syphilis.D)Pyelonephritis.
Exam Review
- A patient is admitted to the emergency department with left-sided chest trauma. Which statement best identifies why the formation of a tension pneumothorax can result in a life-threatening condition for this patient?A)The uninjured lung will hyperinflate because of an increased respiratory rate.B)Affected lung collapses as more air is exhaled through the traumatic injury.C)Trapped air causes collapse of the lung and can reduce the cardiac output.D)More CO2 is retained because weakened alveoli blebs rupture.
- A woman is evaluated by a nurse practitioner. She describes a two-day history of an abnormal vaginal discharge and constant pelvic-area pain. She also states "It hurts to move at all." The pain pattern and other S&S are consistent withA)benign prostatic hypertrophy (BPH).B)ovarian cancer.C)a kidney stone.D)a chlamydia infection.
- A patient diagnosed with chronic kidney disease (CKD) would likely haveA)hypercalcemia; phosphate supplement.B)metabolic alkalosis; low protein diet.C)hypokalemia; diuretic medication.D)hypertension; antihypertensive medication.
- A week after recovering from strep throat, a child is diagnosed with post-streptococcal glomerulonephritis. Expected signs and symptoms (S&S) of a patient diagnosed with glomerulonephritis include which is caused byA)chancres inflaming the glomeruli: syphilis.B)increased urine output: an increased glomerular filtration rate (GFR).C)poor skin turgor: fluid shifting from tissue to blood secondary to hyperproteinemia.D)edema: fluid shifting from blood to tissue secondary to hypoproteinemia.
Exam Review
- A nurse is caring for a patient who has complete kidney failure or end-stage renal disease (ESRD). Which treatment will the nurse anticipate for this patient?A)Large amounts of intravenous (IV) fluids to manage their fluid volume deficit.B)Potassium supplements to increase the serum potassium level.C)Postmortem care since death is near.D)Dialysis or kidney transplantation.
- A woman is upset because of issues with infertility. While talking with the nurse practitioner, she attempts to understand how endometriosis can cause infertility. Which response, by the nurse, indicates an understanding of this condition?A)"Abnormal tissue outside the pelvic cavity causes inflammation and scarring of the reproductive tract."B)"Scar tissue in the pelvic region, called adhesions, are causing a stricture of the urethra."C)"Retrograde menstruation caused a neoplastic condition of the ovaries."D)"An untreated bacterial infection of the reproductive tract is the cause of your infertility."
- A week after recovering from strep throat, a child is diagnosed with post-streptococcal glomerulonephritis. The pathophysiology of glomerulonephritis in this context usually includes:A)inflammatory changes in the glomeruli causes "leaky" glomerular capillaries.B)an autoantibody attack to the renal artery, causing ischemia to the kidney glomerulus.C)the pathological leaking of casts from the glomerular capillaries into the urine.D)a substantial increase in the glomerular filtration rate (GFR).
- A patient states that he is "not peeing nearly as much as usual, even though I am drinking my usual amount of fluids." He voids a small amount of urine to submit for a urinalysis (UA). The specific gravity on the UA is 1.000. The patient’s normal range for urine specific gravity is 1.002 to 1.028.A)is dehydrated; the body is compensating by "hanging onto water."B)has an acute kidney injury; the specific gravity indicates very concentrated urine.C)is developing renal tissue impairment; the kidney is not able to concentrate urine.D)has testicular cancer; the specific gravity indicates an undescended testis.
Exam Review
- A patient presents with acute oliguria. Lab tests are done to pinpoint the cause. The nurse believes the patient has developed intra-renal acute kidney injury (AKI), based on which typical finding?A)Serum creatinine (Cr.): 0.6-1.2B)A 24-hour urine creatinine clearance test result that is higher than normal.C)A serum creatinine of 0.5.D)Casts present in the urinalysis.
- A patient has had chronic kidney disease (CKD) for many years. The patient sustains a hip fracture. The high risk of fractures is related to a(n)A)inability of the kidneys to produce erythropoietin.B)increased ability to absorb calcium from the foods that are eaten.C)decreased ability of the kidneys to activate vitamin D.D)decreased serum phosphate.
- Which one statement is true? VQ ratio: norm = 0.8A)Cigarette smoking is the main cause of COPD but has a much less severe negative impact on the circulatory system.B)A patient with kyphosis and a measured VQ ratio of 0.6 has a decreased ability of inhaling air into their alveoli.C)Clinical manifestations seen in a patient with respiratory acidosis are tachypnea and tingling of the fingers.D)The nurse taking care of a patient with venous insufficiency understands the mechanisms of this disease when she makes sure the feet are lower than the heart.E)The nurse taking care of a patient with venous insufficiency understands the mechanisms of this disease when she makes sure the feet are lower than the heart.
- A young girl with a history of asthma is brought to her family nurse practitioner (FNP). The child is wheezing and has prolonged expirations. The basic etiology of her signs and symptoms (S&S) includes:A)use of accessory muscles for breathing.B)bronchial-lining swelling that prevents ease of exhalation.C)destruction of elastic recoil properties of the lungs.D)difficulty with inhalation due to stiff alveoli that have filled with fluid.
Exam Review
- Which assessment finding is expected in a child diagnosed with croup?A)accessory muscle use, nasal flaring, and wheezing on exhalationB)a normal respiratory rate, thick mucus plugs, and clubbing of the fingersC)fever, a barking cough, increased respiratory rate, and stridorD)frothy pink sputum, crackles on auscultation, and a weak cough
- The signs and symptoms (S&S) of respiratory failure may be identified in the patient who has a(n):A)expiratory wheeze; PCO₂ 36B)respiratory rate of 42; SO₂ 79%C)respiratory rate of 24; pH 7.46D)barking cough; PO₂ 90
- A nurse is examining an overweight elderly man and notices cyanosis and clubbing of the fingers. The nurse suspects _____ and requests a _____.A)hypertension; vision testB)left heart failure; b-type natriuretic peptide (BNP)C)aspiration pneumonia; arterial blood gas (ABG)D)chronic bronchitis; peak flow
- A nurse is listening to the lungs of a hospitalized post-surgical patient and notes diminished breath sounds in the right lower lobe. The patient has an elevated temperature and green sputum. These findings could indicate _____ because of _____.A)nosocomial pneumonia; lung tissue atelectasisB)lung tissue atelectasis; community-acquired pneumoniaC)pulmonary edema; right heart failureD)pulmonary edema; left heart failure
Exam Review
- A patient arrives at the clinic for his yearly physical. His vital signs include a blood pressure of 170/110. The patient is prescribed an ACE (angiotensin-converting enzyme) inhibitor. This medication decreases blood pressure by inhibiting theA)vasoconstrictive properties of the RAAS (renin-angiotensin-aldosterone system)B)vasodilation properties of the RAASC)inotropic properties of the sympathetic nervous system (SNS)D)diuretic properties of the natriuretic peptide system
- A nurse is teaching a patient diagnosed with emphysema to use the pursed-lip method of breathing. The purpose of this method of breathing is to promoteA)oxygen intakeB)strengthening of the diaphragm and intercostal musclesC)carbon dioxide eliminationD)mucus removal
- A patient has been diagnosed with a thrombus in the popliteal vein. When asked what causes deep vein thrombosis (DVT), the nurse would include which factors in a response?A)Increased hydrostatic pressure causing twisted and distorted surface veinsB)Venous congestion and edemaC)Venous stasis, hypercoagulability, and injury to the blood vessel wallD)Plaque rupture, thrombus formation, and infarction
- A patient is newly diagnosed with hypertension. The nurse suggests a dietary sodium reduction to help lower blood pressure. What rationale should the nurse share for reducing sodium intake?A)"Reduced salt makes food taste less appealing, so you will lose weight, reducing your blood pressure."B)"A low-sodium diet has been shown to reduce blood pressure."C)"The blood volume will be decreased after a high intake of sodium."D)"Salt intake and smoking go together; reducing one helps with the other."