NURSING

The nurse working in the ICU knows that chronic elevation of left ventricular end-diastolic pressure will result in the patient displaying which of the following clinical manifestations?

Answers:

A. Petechia and spontaneous bleeding

B. Dyspnea and crackles in bilateral lung bases

C. Muscle cramping and cyanosis in the feet

D. Chest pain and intermittent ventricular tachycardia

Question 93

A 51-year-old patient with a history of alcohol abuse and liver disease has low serum levels of albumin and presents with ascites (excess fluid in his peritoneal space) and jaundice. A health care professional would recognize that which of the following processes is most likely underlying his health problems?

Answers:

A. Insufficient albumin is causing insufficient absorption of fluid into the capillaries.

B. Low albumin contributing to an inability to counter gravitational effects.

C. Low albumin is contributing to excess hydrostatic pressure and inappropriate fluid distribution.

D. Low albumin is inducing hypertension and increased filtration of fluid into interstitial spaces.

Question 94

A community health nurse is teaching a group of recent graduates about the large variety of factors that influence an individual’s health or lack thereof. The nurse is referring to the Healthy People 2020 report from the U.S. Department of Health and Human Services as a teaching example. Of the following aspects discussed, which would be considered a determinant of health that is outside the focus of this report?

Answers:

A.The client has a diverse background by being of Asian and Native American descent and practices various alternative therapies to minimize effects of stress.

B. The client has a family history of cardiovascular disease related to hypercholesterolemia and remains noncompliant with the treatment regime.

C. The client lives in an affluent, clean, suburban community with access to many health care facilities.

D. The client has a good career with exceptional preventative health care benefits.

Question 95

The clinical educator of a hospital medical unit has the mandate of establishing evidence-based practice guidelines for the nursing care on the unit. Which of the following statements most accurately captures a guiding principle of the nurse’s task?

Answers:

A. Evidence-based practice guidelines will be rooted in research rather than nurses’ subjective practice preferences and experiences.

B. Guidelines are synonymous with systematic research reviews.

C. The need for continuity and standardization of guidelines will mean that they will be fixed rather than changeable.

D. The guidelines will combine individual expertise with external systematic evidence.

Question 96

A nurse who provides care in a geriatric subacute medicine unit of a hospital has noted that a large number of patients receive ?-adrenergic blocking medications such as metoprolol. Which of the following statements best conveys an aspect of the use of beta-blockers?

Answers:

A. They counteract arrhythmias and tachycardias by increasing vagal stimulation.

B. They can be used to treat supraventricular arrhythmias and decrease automaticity by depressing phase 4 of the action potential.

C. They decrease myocardial oxygen demand by blocking the release of intracellular calcium ions.

D. They inhibit the potassium current and repolarization, extending the action potential and refractoriness.

Question 97

Which of the following teaching points would be most appropriate for a group of older adults who are concerned about their cardiac health?

Answers:

A. “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.”

B. “Infections of any sort are often a signal that plaque disruption is in danger of occurring.”

C. “The impaired function of the lungs that accompanies pneumonia or chronic obstructive pulmonary disease is a precursor to plaque disruption.”

D. “People with plaque in their arteries experience attacks of blood flow disruption at seemingly random times.”

Question 98

A 40-year-old male client is shocked to receive a diagnosis of mature B-cell lymphoma and is doing research on his diagnosis on the Internet. Which of the following statements that he reads on various Web sites is most reliable?

Answers:

A. “Like most forms of Hodgkin lymphoma, mature B-cell lymphoma often requires radiation treatment.”

B. “Doctors are able to diagnose mature B-cell lymphoma by the presence of Reed-Sternberg cells.”

C. “The lymph nodes are usually affected, and often the spleen and bone marrow.”

D. “Unlike many other lymphomas, mature B-cell lymphoma is often self-limiting, and treatment is focused on symptoms.”

Question 99

Which of the following processes would most likely be considered an anomaly during the cellular phase of inflammation?

Answers:

A. Platelet aggregation

B. Vasoconstriction

C. Migration of phagocytic white cells

D. Macrophage activity

Question 100

A geriatrician has ordered an echocardiogram and stress test for an 80-year-old male client in an effort to gauge the client’s cardiovascular health status.Which of the following changes would the physician most likely identify as an anomaly that is not an expected age-related change?

Answers:

A. Increased resting, supine heart rate

B. Low maximal heart rate and cardiac output

C. Increased left ventricular wall thickness

D. Delayed left ventricular filling

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