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Respiratory
Cardiovascular
Lymph & MISC
Respiratory 2
Cardiovascular 2
100
A 79 y/o client is admitted to the hospital with a diagnosis of bacterial pneumonia. While obtaining the client's history the nurse learns that the client has osteoarthritis, follows a vegetarian diet, and is very concerned with cleanliness. Which of the following would MOST likely be a predisposing factor for the diagnosis of pneumonia? 1. Age 2. Osteoarthritis 3. Vegetarian diet 4. Daily bathing
Age Pneumonia is more common in the elderly. Other factors could be smoking, upper resp. infection, malnutrition, immunosuppression, and chronic illness.
100
You are assessing a patient who is experiencing complications of right sided heart failure. Which of the following clinical findings could be present with this disease? (Select all that apply) a. Pulmonary edema b. Swelling of the feet and ankles c. Weight gain d. shortness of breath
B. swelling of the feet and ankles C. weight gain
100
Which technique is used for palpating lymph nodes? 1. Apply gentle pressure over the nodes with the tips of the fingers 2. Apply firm pressure over the nodes with the pads of the fingers 3. Apply firm pressure anterior to the nodes with the tips of the fingers 4. Apply gentle pressure over the nodes with the pads of the fingers
4. Apply gentle pressure over the nodes with the pads of the fingers
100
The nurse is caring for a client who has asthma. The nurse should conduct a focused assessment to detect which of the following? 1. Increased forced expiratory volume 2. Normal breath sounds 3. Inspiratory and expiratory wheezing 4. Morning headaches
3. Inspiratory and expiratory wheezing
100
You are caring for a patient with left sided heart failure. What question would you ask to confirm the patient is experiencing nocturnal dyspnea? 1. Do you have trouble falling asleep at night? 2. Is it difficult for you to sleep laying flat? 3. Do you ever wake up in the night with severe shortness of breath? 4. How many pillows do you sleep with at night?
3. Do you ever wake up in the night with severe shortness of breath?
200
The nurse assesses the respiratory status of a client who is experiencing an exacerbation of COPD secondary to an upper respiratory tract infection. Which of the following findings would be expected? 1. Normal breath sounds 2. Prolonged inspiration 3. Normal chest movement 4. Coarse crackles and ronchi
4. Coarse crackles and ronchi Expiration is prolonged NOT inspiration
200
A patient presents to the emergency department with 8/10 chest pain. Which of the following questions is MOST important to ask the patient at this time? 1. What does the pain feel like? 2. Do you have a history of heart attacks in your family? 3. What medications are you currently taking? 4. Is your pain really an 8/10?
1. What does the pain feel like?
200
A patient has just underwent a left sided mastectomy and removal of several lymph nodes in the left arm. During follow up with the patient 2 days later you notice that the patient's left arm is swollen. How would you interpret this assessment finding? a. Infection of the left arm b. This is an unexpected finding c. Patient is experiencing lymphedema related to recent lymph node removal d. The patient is in need of drainage of fluid from the left arm to prevent skin damage.
c. Patient is experiencing lymphedema related to recent lymph node removal
200
Which of the following findings would suggest pneumothorax in a trauma victim? 1. Pronounced crackles 2. Inspiratory wheezes 3. Dullness on percussion 4. Absent breath sounds
4. Absent breath sounds
200
Which of the following are tertiary health promotions for cardiovascular disease? (Select all that apply) 1. Exercising to prevent arterial stenosis 2. Blood pressure screenings to detect hypertension 3. Nitroglycerin tablets to manage stable angina 4. Heart catheterization and stent placement following a myocardial infarction
3. Nitro to manage stable angina 4. Heart cath and stent placement following an MI
300
Which of the following health promotion activities should the nurse include in the discharge teaching plan for a client with asthma? 1. Incorporate physical exercise as tolerated into the daily routine 2. Continue use of antibiotics to prevent infection 3. Eliminate stressors in the home and work environment 4. Use sedatives to ensure uninterrupted sleep at night
1. Incorporate physical exercise as tolerated
300
Which of the following risk factors increase a patient's risk of developing hypertension? (Select all that apply) a. Alcohol b. physical activity c. diabetes mellitus d. African American descent e. Being in nursing school (I know I know, but don't pick this one)
a. Alcohol c. DM d. African American descent
300
Examination of a patient in a supine position reveals jugular veins from the base of the neck to the angle of the jaw. This finding indicates: 1. decreased venous return. 2. increased central venous pressure. 3. increased pulmonary artery capillary pressure. 4. left-sided heart failure.
2. Increased central venous pressure
300
During inspection of the respiratory system the nurse documents which finding as abnormal? 1. Skin color consistent with race 2. 1:2 ratio of anteroposterior to lateral diameter 3. Anterior costal angle is 85 degrees 4. Patient leaning forward with arms braced against the knees
4. Patient leaning forward with arms braced against the knees
300
What is a primary health promotion for cardiovascular disease? 1. Smoking cessation 2. Chest X-rays 3. Blood pressure screenings 4. Aspirin medication
1. Smoking cessation
400
When developing a discharge plan to manage the care of a client with COPD the nurse should advise the client to expect to: 1. Develop respiratory infections easily 2. Maintain current status 3. Require less supplemental O2 4. Show permanent improvement
1. Develop respiratory infections easily
400
A patient is suffering from a DVT of the right leg. Which of the following clinical findings would you expect to find when assessing this patient? a. Bilateral swelling of the legs and redness b. The right calf is cool to touch c. Unilateral swelling of the right leg d. The patient experiences pain when the nurse massages the leg
c. Unilateral swelling of the right leg
400
In an assessment for intermittent claudication, the cardiac/vascular nurse assesses for leg pain and cramping with exertion, and then asks the patient: 1. “Does shortness of breath accompany the leg pain?" 2. “Does this same type of pain occur without activity?" 3. “Is the leg pain relieved by rest?" 4. “Is the leg pain relieved with elevation?"
3. Is the leg pain relieved with rest?
400
On auscultation of a patient's lungs the nurse hears a low-pitched, coarse, loud, and low snoring sound. Which term does the nurse use to document this? 1. Rhonchi 2. Wheeze 3. Crackles 4. Pleural friction rub
1. Rhonchi
400
Where are bronchovesicular breath sounds heard? a. Over the trachea b. Over the lateral portions of the lungs c. Over the sternum d. Beside the 6th intercostal space
C. Over the sternum
500
Which finding does the nurse expect when performing tactile fremitus? 1. A vibration of sounds that are equal bilaterally 2. A change in muscle tone when the patient inhales and exhales 3. Symmetric rise of the thorax as the patient speaks, indicating equal expansion 4. Coughing triggered by patient speech, indicating bronchial irritation
1. A vibrations of sounds that are equal bilaterally
500
How is cardiac output calculated?
Heart rate X Stroke volume What is stroke volume?
500
A patient with cardiogenic shock receives a nursing diagnosis of decreased cardiac output. With the appropriate interventions, the anticipated outcome is for the patient to achieve: 1. baseline activity level. 2. baseline cardiac function. 3. reduced anxiety. 4. decreased afterload.
2. Baseline cardiac function
500
On examination, a nurse finds the patient has a productive cough with green sputum and inspiratory crackles. What other findings does this nurse expect during the examination? Select all that apply. a. Dull tones to percussion b. Increased vibration on vocal fremitus c. Fever d. Decreased diaphragmatic excursion e. An increased anterior-posterior chest diameter
A. Dull tones to percussion B. Increased vibration on vocal fremitus C. Fever
500
What differentiates stable angina from unstable angina?
Stable angina- Relieved with rest, aspirin, nitroglycerin Unstable angina- Not relieved with rest, aspirin, or nitro, has a worsening pattern