Question 1
Question
A 52-year-old female is admitted to the cardiac unit with a diagnosis of pericarditis. She asks the nurse to explain where the infection is. In providing an accurate description, the nurse states that the pericardium is:
Answer
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The innermost layer of the heart chambers
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A membranous sac that encloses the heart
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The heart’s fibrous skeleton
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The outer muscular layer of the heart
Question 2
Question
A 50-year-old female received trauma to the chest that caused severe impairment of the primary pacemaker cells of the heart. Which of the following areas received the greatest damage?
Question 3
Question
A cardiologist is teaching about the period that follows depolarization of the myocardium and represents a period during which no new cardiac potential can be propagated. What is the cardiologist describing?
Answer
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Threshold
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Absolute refractory
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Resting
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Hyperpolarization
Question 4
Question
The _____ represents the sum of all ventricular muscle cell depolarization.
Answer
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PR interval
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P wave
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QT interval
-
QRS complex
Question 5
Question
A 65-year-old male develops blockage in the pulmonary artery. As a result of the blockage, blood would first back up into the:
Answer
-
Pulmonary veins
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Aorta
-
Left ventricle
-
Right ventricle
Question 6
Question
Which principle should the nurse remember when planning nursing care for a patient with heart problems? As stated by the Frank-Starling law, there is a direct relationship between the _____ of the blood in the heart at the end of diastole and the _____ of contraction during the next systole.
Answer
-
Viscosity, duration
-
Viscosity, force
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Pressure, duration
-
Volume, force
Question 7
Question
While planning care for a heart patient, which principle should the nurse recall? Right ventricular afterload is affected by:
Answer
-
Right end-diastolic pressure
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Vascular resistance in the systemic vessels
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Pressures in the vena cava
-
Pulmonary vascular resistance
Question 8
Question
A nurse observes a cardiologist multiplying the heart rate by stroke volume. What is the cardiologist measuring?
Answer
-
Cardiac output
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Ejection fraction
-
Vascular resistance
-
Preload
Question 9
Question
A nurse is teaching about the heart. Which information should the nurse include? The chamber of the heart that generates the highest pressure is the:
Answer
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Left atrium
-
Right ventricle
-
Left ventricle
-
Right atrium
Question 10
Question
A patient researches baroreceptors online. Which information indicates a good understanding? Baroreceptors are located in the:
Answer
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Renal artery
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Circle of Willis
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Carotid sinus
-
Superior vena cava
Question 11
Question
A nurse is evaluating the direct end effect of the renin-angiotensin-aldosterone system. Which principle should the nurse remember?
Answer
-
Angiotensin I promotes sodium and water reabsorption by the kidneys.
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Aldosterone increases renal retention of water only.
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Angiotensin II causes systemic vasoconstriction.
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Renin promotes the excretion of sodium and water in the renal tubules.
Question 12
Question
When a patient wants to know about the renin-angiotensin-aldosterone system, what is the nurse’s best response? Conversion of angiotensin I to angiotensin II happens in the:
Answer
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Liver
-
Lungs
-
Heart
-
Kidneys
Question 13
Question
Which statement indicates the nurse understands blood flow? Oxygenated blood flows through the:
Answer
-
Superior vena cava
-
Pulmonary veins
-
Pulmonary artery
-
Cardiac veins
Question 14
Question
A 60-year-old male presents to his primary care provider reporting chest pain. He is diagnosed with atherosclerosis. This disease is caused by:
Answer
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Abnormal thickening and hardening of vessel walls
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Arterial wall thinning and weakening
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Abnormally dilated arteries and veins
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Autonomic nervous system imbalances
Question 15
Question
When a nurse checks the patient for orthostatic hypotension, what did the nurse have the patient do?
Answer
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Stand up
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Physical exertion
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Eat
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Lie down
Question 16
Question
What term should the nurse document for a detached blood clot?
Answer
-
Thromboembolus
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Infarction
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Thrombus
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Embolus
Question 17
Question
A 32-year-old female presents with lower leg pain, with swelling and redness. While obtaining the patient’s history, which finding could have caused her condition?
Answer
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Atherosclerosis
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Heart valve damage
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Bacterial infection
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Venous thrombus
Question 18
Question
A 28-year-old female presents with severe chest pain and shortness of breath. She is diagnosed with pulmonary embolism, which most likely originated from the:
Question 19
Question
Individuals with Raynaud disease need to be counseled to avoid which of the following conditions to prevent severe symptoms?
Answer
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Allergic reactions
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Hot water immersion
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Cold exposure
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Tissue injury
Question 20
Question
A 75-year-old obese female presents to her primary care provider reporting edema in the lower extremities. Physical exam reveals that she has varicose veins. Upon performing the history, which of the following is a possible cause for the varicose veins?
Answer
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Trauma to the deep veins
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Ischemia
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Long periods of standing
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Extreme exercise
Question 21
Question
While planning care for a patient with superior vena cava syndrome (SVCS), which principle should the nurse remember? SVCS is a progressive _____ of the superior vena cava (SVC) that leads to venous distention of the upper extremities and head.
Answer
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Sclerosis
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Distention
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Occlusion
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Inflammation
Question 22
Question
A 56-year-old male is diagnosed with coronary artery disease. Which of the following modifiable risk factors would the nurse suggest the patient change?
Answer
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Smoking cigarettes
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Living arrangements
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Eating meat
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Drinking tomato juice
Question 23
Question
When a patient asks the nurse what is the most common cause of myocardial ischemia, which statement is the correct response? The most common cause of myocardial ischemia is:
Question 24
Question
A 51-year-old male presents with recurrent chest pain on exertion. He is diagnosed with angina pectoris. When he asks what causes the pain, how should the nurse respond? The pain occurs when:
Answer
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The myocardial oxygen supply has fallen below demand.
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The vagus nerve is stimulated.
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Cardiac output has fallen below normal levels.
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Myocardial stretch has exceeded the upper limits.
Question 25
Question
A 51-year-old male is at the health clinic for an annual physical exam. After walking from the car to the clinic, he developed substernal pain. He also reported discomfort in his left shoulder and his jaw, lasting 2 to 3 minutes and then subsiding with rest. He indicates that this has occurred frequently over the past few months with similar exertion. The nurse suspects he is most likely experiencing:
Question 26
Question
A 49-year-old male presents to his primary care provider reporting chest pain. EKG reveals ST elevation. He is diagnosed with myocardial ischemia. Which of the following interventions would be most beneficial?
Answer
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Give an antibiotic to decrease infection.
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Apply oxygen to increase myocardial oxygen supply.
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Encourage exercise to increase heart rate.
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Administer a diuretic to decrease volume.
Question 27
Question
A 60-year-old female had a myocardial infarction. She was brought to the hospital 30 minutes later. She survived, but now the nurse is providing care for impaired ventricular function because:
Answer
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There is a temporary alteration in electrolyte balance.
-
The resulting ischemia leads to hypoxic injury and myocardial cell death.
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The cells become hypertrophic.
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There is too much stress on the heart.
Question 28
Question
While planning care, the nurse remembers which principle? In valvular _____, the valve opening is constricted and narrowed because the valve leaflets, or cusps, fail to open completely.
Answer
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Insufficiency
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Incompetence
-
Stenosis
-
Regurgitation
Question 29
Question
A 60-year-old female was diagnosed with mitral stenosis. As a result, the nurse realizes the patient has incomplete emptying of the:
Answer
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Right atrium
-
Right ventricle
-
Left ventricle
-
Left atrium
Question 30
Question
A 72-year-old female has a history of hypertension and atherosclerosis. An echocardiogram reveals backflow of blood into the left ventricle. Which of the following is the most likely diagnosis documented on the chart?
Answer
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Mitral stenosis
-
Aortic stenosis
-
Mitral regurgitation
-
Aortic regurgitation
Question 31
Question
Most cases of combined systolic and diastolic hypertension have no known cause and are documented on the chart as _____ hypertension.
Answer
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Primary
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Acquired
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Congenital
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Secondary
Question 32
Question
Which characteristic changes should the nurse keep in mind while caring for a patient with left heart failure? As left heart failure progresses:
Answer
-
Systemic vascular resistance decreases.
-
Left ventricular preload increases.
-
Pulmonary vascular resistance decreases.
-
Left end-diastolic volume decreases.
Question 33
Question
A 65-year-old male with a history of untreated hypertension is now experiencing left heart failure. A nurse recalls his untreated hypertension led to:
Answer
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Inhibition of renin and aldosterone
-
Alterations in alpha and beta receptor function
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Ventricular dilation and wall thinning
-
Myocardial hypertrophy and ventricular remodeling
Question 34
Question
A 59-year-old female is diagnosed with left ventricular failure. If a decrease in kidney perfusion occurs, the nurse knows this would ultimately cause:
Answer
-
Decreased cardiac oxygen demand
-
Decreased left ventricular preload
-
Increased systemic vascular resistance
-
Increased pulmonary capillary permeability
Question 35
Question
When a patient with left heart failure starts to have a cough and dyspnea, which principle should the nurse remember? Pulmonary symptoms, common to left heart failure, are a result of:
Question 36
Question
A 65-year-old male is diagnosed with chronic pulmonary disease and elevated pulmonary vascular resistance. Which of the following heart failures should the nurse assess for in this patient?
Answer
-
Right heart failure
-
Low-output failure
-
Left heart failure
-
High-output failure
Question 37
Question
When a person is in shock, a nurse remembers impairment in cellular metabolism is cause by:
Answer
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Inadequate tissue perfusion
-
Lack of nervous or endocrine stimulation
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Free radical formation
-
Release of toxic substances
Question 38
Question
One consequence of switching from aerobic to anaerobic cellular metabolism during shock states is:
Question 39
Question
A 27-year-old male is admitted to a neurologic unit with a complete C-5 spinal cord transection. On initial assessment, he is bradycardic, hypotensive, and hyperventilating. He appears to be going into shock. The most likely mechanism of his shock is:
Answer
-
Vasodilation caused by gram-negative bacterial infection
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Vasodilation caused by a decrease in sympathetic stimulation
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Hypovolemia caused by evaporative fluid losses
-
Hypovolemia caused by blood loss
Question 40
Question
A 15-year-old male who is allergic to peanuts eats a peanut butter cup. He then goes into anaphylactic shock. Which assessment findings will the nurse assess for?
Answer
-
Bronchoconstriction, hives or edema, and hypotension
-
Hypertension, anxiety, and tachycardia
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Fever, hypotension, and erythematous rash
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Bradycardia, decreased arterial pressure, and oliguria
Question 41
Question
For an infection to progress to septic shock, which of the following factors should the nurse determine occurred?
Answer
-
The myocardium must be impaired.
-
Bacteria must enter the bloodstream.
-
The infection must be gram negative.
-
The individual must be immunosuppressed.
Question 42
Question
Which patient is most prone to multiple organ dysfunction syndrome (MODS)? In a patient with:
Question 43
Question
Which is the most common type of congenital heart defect the nurse should assess for in infants?
Answer
-
Atrioventricular canal defect
-
Ventricular septal defect (VSD)
-
Atrial septal defect (ASD)
-
Tetralogy of Fallot
Question 44
Question
A newborn experiences frequent periods of cyanosis, usually occurring during crying or after feeding. Which of the following is the most likely diagnosis the nurse will observe on the chart?
Answer
-
Atrial septal defect (ASD)
-
Atrioventricular canal (AVC) defect
-
Ventricular septal defect (VSD)
-
Tetralogy of Fallot
Question 45
Question
A newborn baby is severely cyanotic. An echocardiogram reveals transposition of the great arteries. A nurse assesses for which of the following, as it usually occurs with this defect?
Answer
-
Ventricular septal defect (VSD)
-
The aorta leaving the right ventricle
-
Atrial septal defect (ASD)
-
The pulmonary artery leaving the right ventricle
Question 46
Question
A newborn child is diagnosed with tetralogy of Fallot. What symptoms would the nurse expect to observe in the child?
Question 47
Question
A 5-year-old female is found to have hypertension during three separate visits to her primary care provider. The nurse would expect tests to suggest that the hypertension is secondary to:
Answer
-
Hyponatremia
-
Hypocalcemia
-
Renal disease
-
Brain tumor
Question 48
Question
A 1-month-old infant visits his primary care provider for a well-baby check. Physical exam reveals decreased cardiac output, hypotension, tachycardia, and a loud murmur suggestive of aortic stenosis. Which of the following would be expected with this diagnosis?
Answer
-
Ventricular hypertrophy
-
Atrial rigidity
-
Decreased contractility
-
Atrial dilation
Question 49
Question
The nasopharynx is lined with a ciliated mucosal membrane with a highly vascular blood supply. The nurse is discussing the functions of this membrane. Which information should be included? One function of the membrane is to:
Answer
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Humidify air
-
Exchange gases
-
Absorb air
-
Cool air
Question 50
Question
A 42-year-old male was involved in a motor vehicle accident during which he suffered a severe head injury. He died shortly after the accident from loss of respiration. The nurse suspects the area of the brain most likely involved is the:
Answer
-
Basal ganglia
-
Brainstem
-
Thalamus
-
Cerebral cortex
Question 51
Question
While planning care for a patient with respiratory difficulty and retaining too much carbon dioxide, which principle should the nurse recall? _______ would be stimulated in an attempt to maintain a normal homeostatic state.
Question 52
Question
A patient asks how oxygen is transported in the body. What is the nurse’s best response? Most of the oxygen (O2) is transported:
Question 53
Question
Which principle should the nurse remember while planning care for a patient with respiratory problems? Diffusion of respiratory gases takes place at the:
Question 54
Question
A 10-year-old female develops pneumonia. Physical exam reveals subcostal and intercostal retractions. She reports that breathing is difficult and she feels she cannot get enough air. What term should the nurse use to document this condition?
Answer
-
Dyspnea
-
Cyanosis
-
Orthopnea
-
Hyperpnea
Question 55
Question
A nurse is teaching staff about pulmonary edema. Which information should the nurse include? The most common cause of pulmonary edema is:
Answer
-
Lung cancer
-
Asthma
-
Left heart failure
-
Right heart failure
Question 56
Question
A 50-year-old male presents with hypotension, hypoxemia, and tracheal deviation to the left. Tests reveal that the air pressure in the pleural cavity exceeds barometric pressure in the atmosphere. Based upon these assessment findings, what does the nurse suspect the patient is experiencing?
Question 57
Question
A 20-year-old male presents to his primary care provider reporting difficulty breathing when lying down. What term should the nurse use to document this condition?
Answer
-
Dyspnea
-
Tachypnea
-
Apnea
-
Orthopnea
Question 58
Question
A 42-year-old female presents with dyspnea; rapid, shallow breathing; inspiratory crackles; decreased lung compliance; and hypoxemia. Tests reveal a fulminant form of respiratory failure characterized by acute lung inflammation and diffuse alveolocapillary injury. Which of the following is the most likely diagnosis the nurse will observe on the chart?
Answer
-
Malignant respiratory failure
-
Acute respiratory distress syndrome (ARDS)
-
Sarcoidosis
-
Postoperative respiratory failure
Question 59
Question
A nurse is preparing to teach the staff about asthma. Which information should the nurse include? Airway obstruction contributing to increased airflow resistance and hypoventilation in asthma is caused by:
Answer
-
Collapse of the cartilaginous rings in the bronchi
-
Mucus secretion, bronchoconstriction, and airway edema
-
Type II alveolar cell injury and decreased surfactant
-
Alveolar fibrosis and pulmonary edema
Question 60
Question
A 25-year-old male presents with chronic bronchitis of 5 months’ duration. When obtaining the patient’s history, which of the following findings is most likely to cause this condition?
Answer
-
Cigarette smoke
-
Recurrent pneumonias
-
Air pollution
-
Chronic asthma
Question 61
Question
A 30-year-old female received a severe head injury in a motor vehicle accident. She is now experiencing respiratory abnormalities characterized by alternating periods of deep and shallow breathing with periods of apnea. What term should the nurse use when charting this condition?
Answer
-
Orthopnea
-
Apnea
-
Frank-Starling
-
Cheyne-Stokes
Question 62
Question
When the nurse observes a diagnosis of nosocomial pneumonia, the patient generally acquires this pneumonia:
Answer
-
At day care centers
-
During hospitalization
-
On airplanes
-
In the winter season
Question 63
Question
Which of the following patients is at highest risk for developing pulmonary embolism (PE)?
Answer
-
36-year-old woman with a history of alcohol abuse who is recovering from a gastric ulcer
-
28-year-old woman who had a baby 6 months earlier
-
21-year-old male with a hemophilia bleeding disorder
-
72-year-old male who is recovering from hip replacement surgery in the hospital
Question 64
Question
When a patient has a massive pulmonary embolism (PE), what complications will the nurse monitor for?
Answer
-
Damage to the lung microcapillaries
-
Chronic obstructive pulmonary disease (COPD)
-
Shock and death
-
Disseminated intravascular coagulation (DIC)
Question 65
Question
A 1-year-old female is diagnosed with croup. When the parent asks what caused this, what is the nurse’s best response? The most likely cause of this disease is:
Answer
-
Viral infection
-
Bacteria
-
Allergy
-
Acute hyperventilation
Question 66
Question
A 6-month-old female presents with rhinorrhea, cough, poor feeding, lethargy, and fever. She is diagnosed with bronchiolitis. Which of the following will the nurse most likely observe on the culture report?
Question 67
Question
While planning care, a nurse recalls respiratory distress and hypoxemia in laryngotracheobronchitis are caused by:
Question 68
Question
While reviewing lab results, to help confirm a diagnosis of cystic fibrosis in a 1-year-old child which substance will be present in the child’s sweat?
Answer
-
Carbonic acid
-
Potassium
-
Sodium chloride
-
Magnesium
Question 69
Question
To prevent sudden infant death syndrome, the nurse should instruct parents to:
Answer
-
Keep the infant’s room very warm.
-
Breast-feed their infants.
-
Always lay infants down on their backs to sleep.
-
Place infants on a soft mattress for sleeping.
Question 70
Question
A newborn has respiratory distress syndrome. When obtaining the patient’s history, which of the following is the most important predisposing factor for this condition?
Question 71
Question
During a respiratory assessment of an infant with respiratory distress syndrome, a sinking in the supraclavicular and intercostal areas of the thorax was noted with inspiration. This observation is documented as:
Answer
-
Grunting
-
Retractions
-
Tachypnea
-
Nasal flaring
Question 72
Question
When a staff member asks what the patent opening between the aorta and pulmonary artery in a fetus is called, how should the nurse reply? It is the:
Answer
-
Ductus arteriosus
-
Foramen ovale
-
Sinus venosus
-
Septal defect
Question 73
Question
A 20-year-old male is in acute pain. An arterial blood gas reveals decreased carbon dioxide (CO2) levels. Which of the following does the nurse suspect is the most likely cause?
Answer
-
Hypoventilation
-
Hyperventilation
-
Cyanosis
-
Apnea
Question 74
Question
A 65-year-old female with emphysema presents to the ER for difficulty breathing. Physical exam reveals bluish skin and mucous membranes. How should the nurse chart this condition? Patient has:
Answer
-
Hemoptysis
-
Hematemesis
-
Ischemia
-
Cyanosis
Question 75
Question
A 28-year-old male reports to his primary care provider that he has had a cold for a week and is coughing up bloody secretions. When giving report, what term should the nurse use to describe this condition?
Answer
-
Hematemesis
-
Hemoptysis
-
Rhinitis
-
Cyanosis