NURSING

Question 33

In which of the following hospital patients would the care team most realistically anticipate finding normal cholesterol levels?

Answers:

A. A 44-year-old male admitted for hyperglycemia and with a history of diabetic neuropathy

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

C. A 77-year-old female admitted for rheumatoid arthritis exacerbation who is receiving hormone replacement therapy and with a history of hypothyroidism

D. A morbidly obese 50-year-old female who is taking diuretics and a beta-blocker to treat her hypertension

Question 34

As of November 1, 2012, there were a total of 10 confirmed cases of Hantavirus infection in people who were recent visitors (mid-June to end of August, 2012) to Yosemite National Park. Three visitors with confirmed cases died. Health officials believe that 9 out of the 10 people with Hantavirus were exposed while staying in Curry Village in the Signature Tent Cabins. This is an example of

Answers:

A. the low rate of morbidity one can expect while traveling to Yosemite National Park.

B. the prevalence of Hantavirus one can anticipate if he or she is going to vacation in Yosemite National Park.

C. what the anticipated mortality rate would be if a family of five were planning to vacation in Yosemite National Park.

D. the incidence of people who are at risk for developing Hantavirus while staying in Yosemite National Park.

Question 35

A 1-year-old child who has experienced low platelet counts and bacterial susceptibility has been admitted to a pediatric medical unit of a hospital for treatment of Wiskott-Aldrich syndrome. The nurse who has admitted the child to the unit would anticipate which of the following short-term and longer-term treatment plans?

Answers:

A. Neutropenic precautions; fresh frozen plasma transfusions; treatment of gastrointestinal symptoms

B. Transfusion of clotting factors XII and XIII and serum albumin; splenectomy

C. Intravenous immunoglobulin (IVIG) treatment; thyroidectomy

D. Treatment of eczema; management of bleeding; bone marrow transplant

Question 36

A 60-year-old woman is suspected of having non-Hodgkin lymphoma (NHL). Which of the following aspects of her condition would help to rule out Hodgkin lymphoma?

Answers:

A. The lymph nodes involved are located in a large number of locations in the lymphatic system.

B. The woman complains of recent debilitating fatigue.

C. Her neoplasm originates in secondary lymphoid structures.

D. The presence of Reed-Sternberg cells has been confirmed.

Question 37

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?

Answers:

A. Peripheral dilation is associated with decreased stroke volume and ejection fraction.

B. Increased cardiac demand causes engorgement of systemic blood vessels, of which the jugular vein is one of the largest.

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

D. Heart valves are not capable of preventing backflow in cases of atrial congestion.

Question 38

A nurse who works on a pediatric cardiology unit of a hospital is providing care for an infant with a diagnosis of tetralogy of Fallot. Which of the following pathophysiologic results should the nurse anticipate?

Answers:

A. Blood outflow into the pulmonary circulation is restricted by pulmonic valve stenosis.

B. There is a break in the normal wall between the right and left atria that results in compromised oxygenation.

C. The aortic valve is stenotic, resulting in increased afterload.

D. The right ventricle is atrophic as a consequence of impaired myocardial blood supply.

Question 39

Which of the following hypertensive individuals is most likely to have his or her high blood pressure diagnosed as secondary rather than essential?

Answers:

A. A 40-year-old smoker who eats excessive amounts of salt and saturated fats

B. A 69-year-old woman with a diagnosis of cardiometabolic syndrome

C. An African American man who leads a sedentary lifestyle

D. A 51-year-old male who has been diagnosed with glomerulonephritis

Question 40

A 72-year-old female has been told by her physician that she has a new heart murmur that requires her to go visit a cardiologist. Upon examination, the cardiologist informs the patient that she has aortic stenosis. After the cardiologist has left the room, the patient asks, “What caused this [aortic stenosis] to happen now?” The clinic nurse responds,

Answers:

A.“Aortic stenosis is commonly seen in elderly patients.Basically, there is a blockage in the valve that is causing blood to pool, causing decreased velocity of flow.”

B.“Because of the high amount of energy it takes to push blood through the aortic valve to the body, your valve is just had to work too hard and it is weakening.”

C.“This is caused by a tear in one of the papillary muscles attached to the valve. They can do a procedure where they thread a catheter into the heart and reattach the muscle ends.”

D. “Heart murmurs result from tumultuous flow through a diseased heart valve that is too narrow and stiff. This flow causes a vibration called a murmur.”

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