1. Which of the following teaching points would be most appropriate for a group of older adults who are concerned about their cardiac health?
A) "People with plaque in their arteries experience attacks of blood flow disruption at seemingly random times.
B) "The plaque that builds up in your heart vessels obstructs the normal flow of blood and can even break loose and lodge itself in a vessel.
2. A 34-year-old man who is an intravenous drug user has presented to the emergency department with malaise, abdominal pain, and lethargy. The health care team wants to rule out endocarditis as a diagnosis. Staff of the department would most realistically
B) Echocardiogram, blood cultures, temperature
3. A patient has been diagnosed with mitral valve stenosis following his recovery from rheumatic fever. Which of the following teaching points would be most accurate to convey to the patient?
A) "The normal tissue that makes up the valve between the right
B) "Your mitral valve isn't opening up enough for blood to flow into the part of your heart that sends blood into circulation.
4. Four patients were admitted to the emergency department with severe chest pain. All were given preliminary treatment with aspirin, morphine, oxygen, and nitrates and were monitored by ECG. Which patient most likely experienced myocardial infarction?
A)
C) An 80-year-old woman whose pain started at 6 a.m. shortly after awakening and was not relieved by nitrates or rest; the ECG showed ST-segment elevation with inverted T waves and abnormal Q waves; levels of cardiac markers subsequently rose
5. A 13-year-old boy has had a sore throat for at least a week and has been vomiting for 2 days. His glands are swollen, and he moves stiffly because his joints hurt. His parents, who believe in "natural remedies," have been treating him with various herb
B) Mitral valve stenosis
6. A physician has ordered the measurement of a cardiac patient's electrolyte levels as part of the patient's morning blood work. Which of the following statements best captures the importance of potassium in the normal electrical function of the patient'
B) Potassium is central to establishing and maintaining the resting membrane potential of cardiac muscle cells.
7. An ECG technician is placing leads on a patient who has presented to the emergency department with a sudden onset of chest pain. The technician would recognize which of the following facts about the placement of leads and the achievement of a clinicall
B) The chest leads measure electrical activity on the horizontal plane, while limb leads measure it on the vertical plane.
8. A number of patients on an acute cardiac care unit of a hospital have diagnoses of impaired cardiac conduction. Which of the following patients is most deserving of immediate medical attention?
A) A 46-year-old man whose cardiac telemetry shows him to
B) A 69-year-old woman who has entered ventricular fibrillation.
9. A 71-year-old man is slated for pacemaker insertion for treatment of a third-degree AV block. The man's nurse has been educating him about his diagnosis and treatment and answering the numerous questions he has about his health problem. Which of the fo
C) "The root problem is that the top chambers of your heart and the bottom chambers of your heart aren't coordinating to pump blood efficiently.
10. A 72-year-old woman with a recent onset of syncopal episodes has been referred to a cardiologist by her family physician. As part of the patient's diagnostic workup, the cardiologist has ordered her to wear a Holter monitor for 24 hours. Which of the
C) Accurate interpretation of the results requires correlating the findings with the activity that the woman was doing at the time of recording.
11. A 31-year-old woman with a congenital heart defect reports episodes of lightheadedness and syncope, with occasional palpitations. A resting electrocardiogram reveals sinus bradycardia and she is suspected of having sick sinus syndrome. Which of the fo
D) Holter monitoring
12. A nurse will be providing care for a female patient who has a diagnosis of heart failure that has been characterized as being primarily right-sided. Which of the following statements best describes the presentation that the nurse should anticipate?
A)
C) The patient has pitting edema to her ankles and feet bilaterally, decreased activity tolerance, and occasional upper right quadrant pain.
13. 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 likely to most benefit the man?
A) Resolution of compensatory pulmonary edema and heart arrh
C) Infusion of normal saline of Ringer lactate to maintain the vascular space
14. 1. A 55-year-old male who is beginning to take a statin drug for his hypercholesterolemia is discussing cholesterol and its role in health and illness with his physician. Which of the following aspects of hyperlipidemia would the physician most likely
B) HDL cholesterol is often characterized as being beneficial to health.
15.In which of the following hospital patients would the care team most realistically anticipate finding normal cholesterol levels?
A) A. A 44-year-old male admitted for hyperglycemia and with a history of diabetic neuropathy
B) B. A 77-year-old female ad
C) C. A 51-year-old male with a diagnosis of hemorrhagic stroke and consequent unilateral weakness
16. A nurse practitioner is instructing a group of older adults about the risks associated with high cholesterol. Which of the following teaching points should the participants try to integrate into their lifestyle after the teaching session? Circle all t
D. "Your family history of hypercholesterolemia is important, but there are things you can do to compensate for a high inherited risk.
17. . A Patient is reading a brochure on atherosclerosis while in the waiting room of a medical clinic. Which of the following excerpts from the educational brochure warrants correction?
A) A. "Because smoking causes a permanent increase in your risk of h
A) A. "Because smoking causes a permanent increase in your risk of heart disease, it's best not to start.
A nurse is providing care for a patient who has a history of severe atherosclerosis. Which of the following clinical manifestations of the patient's illness would the nurse be most justified in anticipating?
A. Motor deficits in muscles distal to plaque f
D. Aneurysm formation due to weakening of blood vessel walls
19. Which of the following assessment findings in a newly admitted 30-year-old male patient would be most likely to cause his physician to suspect polyarteritis nodosa?
A. The man's blood work indicates polycythemia (elevated red cells levels) and leukocy
B. The man's blood pressure is 178/102 and he has abnormal liver function tests.
A 70-year-old male patient presents to the emergency department complaining of 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. What would his ca
C. Atherosclerotic occlusive disease necessitating thrombolytic therapy
21. 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 physician's most appropriate response?
A.
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.
22. During a routine physical examination of a 66-year-old woman, her nurse practitioner notes a pulsating abdominal mass and refers the woman for further treatment. The nurse practitioner is explaining the diagnosis to the patient, who is unfamiliar with
B. Hypertension is a frequent modifiable contributor to aneurysms.
The renin-angiotensin-aldosterone mechanism is invoked in renal artery stenosis because that will initiate increase secretion of renin by the kidney.
A. True
B. False
A. True
A 44-year-old female who is on her feet for the duration of her entire workweek has developed varicose veins in her legs. What teaching point would her care provider be most justified in emphasizing to the woman?
A. "Once you have varicose veins, there's
A. "Once you have varicose veins, there's little that can be done to reverse them.
25. Age is a very important risk factor in ischemic heart disease.
A. True
B. False
A. True
Why would it be helpful for patients with high cardiovascular risk factors who eat even moderate amounts of meat to include grain cereals in their diets?
A. The fiber in grain cereals will move the meat through the digestive system more easily.
B. Grain c
B. Grain cereals contain high levels of folate, which works with the B vitamins and riboflavin to metabolize the homocysteine found in animal protein.
Hypertension has no effect on the atherosclerotic process.
A. True
B. False
B. False
28. During a prenatal education class, an expectant mother tells the group about a friend whose blood pressure became so high during pregnancy that she had to be admitted to the hospital. Which of the following statements should the nurse include in respo
c. "Essentially, experts don't really know why so many pregnant women develop high blood pressure.
28. A number of older adults have come to attend a wellness clinic that includes both blood pressure monitoring and education about how to best control blood pressure. Which of the leader's following teaching points is most accurate?
A. "It's important to
C. "Too much alcohol, too little exercise, and too much body fat all contribute to high blood pressure.
A physician is providing care for several patients on a medical unit of a hospital. In which of the following patient situations would the physician be most likely to rule out hypertension as a contributing factor?
A. A 61-year-old man who has a heart val
A. A 61-year-old man who has a heart valve infection and recurrent fever
An autopsy is being performed on a 44-year-old female who died unexpectedly of heart failure. Which of the following components of the pathologist's report is most suggestive of a possible history of poorly controlled blood pressure?
A. "Scarring of ureth
D. "Arterial sclerosis of subcortical brain regions noted.
Which of the following hypertensive individuals is most likely to have his or her high blood pressure diagnosed as secondary rather than essential?
A. A 51-year-old male who has been diagnosed with glomerulonephritis
B. An African American man who leads a
A. A 51-year-old male who has been diagnosed with glomerulonephritis
33. True or False. Circle the correct answer.
Bronchiectasis is an irreversible dilatation of the bronchi caused by suppurative bronchial infections in an obstructed bronchus.
True
34. Which of the following is characteristic of stable angina pectoris?
a. It is relieved by rest or medication.
b. It usually occurs at rest or at night.
c. Patients are at very high risk for immediate myocardial infarction.
d. It is usually caused by co
a. It is relieved by rest or medication.
35. True or false? Most pericarditis is caused by viral infection.
true
36. Bilirubin is a normal major pigment of bile; its excess accumulation within cells is evidenced clinically by a yellow discoloration of the skin and sclera, a condition called....
Jaundice
. James Whitlow, a 75-year-old marathon runner has suffered a fractured hip in a fall. Postoperatively the patient sustains complications, including a myocardial infarction. He is on bed rest at this time for 10 days.
- What is the major concern for this
The risk of pulmonary embolism is high
38. A -years-old is diagnosed with croup. His mother is calling you from her home and is asking what she can do to help her child feel better. What are the two advices you should give her?
Tell the mother to humidify the air (take the child in the bathroom when hot water is running) and calm down the child....................................................................
39. Red blood cells contain the protein__, which is used to transport oxygen from the lungs to the tissues.
Hemoglobin
Which of the following statements best conveys an aspect of the respiratory pressures that govern ventilation?
Intrapleural pressure slightly exceeds that of the inflated lung
The chest wall exerts positive pressure on the lungs that contributes to expira
Intrapleural pressure slightly exceeds that of the inflated lung
A 44-year-old woman developed calf pain during a transatlantic flight followed by acute shortness of breath upon arrival at her destination. She was subsequently diagnosed with a pulmonary embolism (PE), which resolved with anticoagulant therapy. Which of
A) She was short of breath because ventilation was occurring but perfusion was inadequate.
A nurse on a respiratory unit of a hospital is providing care to a patient with end-stage lung disease. Consequently, measurement of the patient's arterial blood gases indicates increased PCO2. Which of the following associated consequences would the nurs
C) Higher than normal production of H+
Following a winter power outage, a patient who had been using a home gasoline generator began to experience dizziness and headaches and was diagnosed with carbon monoxide poisoning. What is the goal of hyperbaric oxygen treatment for carbon monoxide poiso
A) To increase the amount of oxygen dissolved in plasma
A family physician is performing patient teaching about the influenza virus with each patient who has come to the clinic to receive that year's vaccine. Which of the following statements by patients 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.
A 66-year-old male presents to the emergency department accompanied by his wife who claims that he has been acting confused. The man is complaining of a sudden onset of severe weakness and malaise and has a dry cough and diarrhea. His temperature is 102.8
C) Legionnaire disease
46. A 62-year-old female smoker is distraught at her recent diagnosis of small cell lung cancer (SCLC). How can her physician most appropriately respond to her?
A) "I'm sure this is very hard news to hear, but be aware that with aggressive treatment your
B) "This is very difficult to hear, I'm sure, and we have to observe to see if it spreads because that often happens.
A 3-year-old boy has developed croup following a winter cold. His care provider would recognize that which of the following causative microorganisms and treatments are most likely?
A) Respiratory syncytial virus; treatment with intubation
B) Parainfluenza
B) Parainfluenza virus; treatment with a mist tent and oxygen therapy
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 of the following teaching points is most justifiable?
A) "Research has shown that viruses
A) "Research has shown that viruses may actually be a factor in many children's asthma.
Which of the following residents of a long-term care facility is most likely to be exhibiting the signs and symptoms of chronic obstructive pulmonary disease (COPD)?
A) A 79-year-old lifetime smoker who is complaining of shortness of breath and pain on de
C) An 81-year-old male who has a productive cough and recurrent respiratory infections
A nurse is providing care for a patient who has been admitted to a medical unit with a diagnosis of bronchiectasis. Which of the following signs and symptoms should the nurse expect to find during physical assessment of the patient and review of the patie
A) Recurrent chest infections
B) Production of purulent sputum
D) Recent surgery
Which of the following patients are displaying known risk factors for the development of pulmonary emboli? Select all that apply.
A) A patient who is immobilized following orthopedic surgery
B) A patient who has impaired Cl- and Na+ regulation
C) A patien
A) A patient who is immobilized following orthopedic surgery
D) A patient who is a smoker and takes oral contraceptives
A short, nonsmoking middle-aged man presents to the emergency department with left-sided chest pain and a cough. He says that the pain started abruptly, just after lunch, and that breathing and coughing make it worse. He denies recent injury. He is breath
C) Pleuritis related to infection
An African American woman brings her 5-year-old son to the emergency department at 6 a.m. The boy is wheezing and short of breath and has a dry cough. The mother says that he has always been very healthy, and that he went to bed with only a slight cold an
C) Asthma
54. Staff at an inner-city homeless shelter send 46-year-old Henry Ship by ambulance to a local hospital after he begins coughing up blood. On arrival at the emergency room, he is feverish and says that he has felt very fatigued for several weeks. He also
b. Tuberculosis