MEDCONNOISSEURLIBRARIES.COMg
g
g
MEDCONNOISSEURLIBRARIES.COMg
g
, MEDCONNOISSEURLIBRARIES.COMg
g
ClinicalgReasoninggCasesgingNursingg7thgEditiongHardinggSnydergTestgBankg
g
Chapterg1.gPerfusiong
g
MULTIPLEgCHOICEg
1. Thegnursegisgexplaininggtogagstudentgnursegaboutgimpairedgcentralgperfusion.gThegnursegk
nowsgthegstudentgunderstandsgthisgproblemgwhengthegstudentgstates,gCentralgperfusiong
a. isgmonitoredgonlygbygthegphysician.g
b. involvesgthegentiregbody.g
c. isgdecreasedgwithghypertension.g
d. isgtoxicgtogthegcardiacgsystem.g
ANS:gBg
Centralgperfusiongdoesginvolvegthegentiregbodygasgallgorgansgaregsuppliedgwithgoxygengandgvitalg
nutrients.gThegphysiciangdoesgnotgcontrolgthegbodysgabilitygforgperfusion.gCentralgperfusiongisgn
otgdecreasedgwithghypertension.gCentralgperfusiongisgnotgtoxicgtogthegcardiacgsystem.g
2. Agpatientgwasgdiagnosedgwithghypertension.gThegpatientgasksgthegnurseghowgthisgdisease
gcouldghaveghappenedgtogthem.gThegnursesgbestgresponsegisgHypertensiong
a. happensgtogeveryonegsoonergorglater.gDontgbegconcernedgaboutgit.g
b. canghappengfromgeatinggagpoorgdiet,gsogchangegwhatgyougaregeating.g
c. canghappengfromgarterialgchangesgthatgimpedegthegbloodgflow.g
d. happensgwhengpeoplegdognotgexercise,gsogyougshouldgwalkgeverygday.g
ANS:gCg
Hardeninggofgthegarteriesgfromgatherosclerosisgcangcauseghypertensiongingthegpatient.g
Hypertensiongdoesgnotghappengtogeveryone.gChanginggthegpatientsgdietgandgexercisinggmaygbegag
positiveglifegchange,gbutgtheseganswersgdognotgexplaingtogthegpatientghowgthegdiseasegcouldghave
ghappened.g
3. Thegpatientgasksgthegnursegtogexplaingthegsinoatrialgnodegingthegheart.gThegnursesgbestgre
sponsegwouldgbe,gThegsinoatrialgnodeg
a. providesgthegheartgwithgthegstimulationgtogbeatgingagnormalgrhythm.g
b. protectsgthegheartgfromgatheroscleroticgchanges.g
c. providesgthegheartgwithgoxygenatedgblood.g
d. protectsgthegheartgfromginfection.g
g
MEDCONNOISSEURLIBRARIES.COMg
g
, MEDCONNOISSEURLIBRARIES.COMg
g
ANS:gAg
Thegsinoatrialgnodegisgthegnaturalgpacemakergofgthegheart,gandgitgassistsgthegheartgtogbeatgingag
normalgrhythm.gThegsinoatrialgnodegdoesgnotgprotectgfromgatheroscleroticgchangesgorginfection,g
andgitgdoesgnotgdirectlygprovidegthegheartgwithgoxygenatedgblood.g
4. Thegpatientgisgbroughtgtogthegemergencygdepartmentgaftergagmotorgvehiclegaccident.gTheg
patientgisgdiagnosedgwithginternalgbleeding.gThegnursesgprimarygconcerngisgtogmonitorgforg
a. mentalgalertness.g
b. perfusion.g
c. pain.g
d. reactiongtogmedications.g
ANS:gBg
Perfusiongisgthegcorrectganswer,gbecausegwithginternalgbleeding,gthegnursegshouldgmonitorgvit
algsignsgtogbegsuregperfusiongisghappening.gMentalgalertness,gpain,gandgmedicationgreactionsg
aregimportantgbutgnotgthegprimarygconcern.g
5. Agpatientsgserumgelectrolytesgaregbeinggmonitored.gThegnursegnoticesgthatgthegpotassium
glevelgisglow.gThegnursegknowsgthatgthegpatientgshouldgbegobservedgforg
a. tissuegischemia.g
b. braingmalformations.g
c. intestinalgblockage.g
d. cardiacgdysthymia.g
ANS:gDg
Cardiacgdysthymiagisgagpossibilitygwhengserumgpotassiumgisghighgorglow.gTissuegischemia,gbrain
gmalformations,gorgintestinalgblockagegdognotghavegagdirectgcorrelationgtogpotassiumgirregularitie
s.g6.gAgnursegisgexplaininggtogagstudentgnursegaboutgperfusion.gThegnursegknowsgthegstudentgund
erstandsgthegconceptgofgperfusiongwhengthegstudentgstates,gPerfusiong
a. isgagnormalgfunctiongofgthegbody,gandgIgdontghavegtogbegconcernedgaboutgit.
g
b. isgmonitoredgbygthegphysician,gandgIgjustgfollowgorders.g
c. isgmonitoredgbygvitalgsignsgandgcapillarygrefill.g
d. variesgasgagpersongages,gsogIgwouldgexpectgchangesgingthegbody.g
ANS:gCg
g
MEDCONNOISSEURLIBRARIES.COMg
g
, MEDCONNOISSEURLIBRARIES.COMg
g
Thegbestgmethodgtogmonitorgperfusiongisgtogmonitorgvitalgsignsgandgcapillarygrefill.gThisgallowsgt
hegnursegtogknowgifgperfusiongisgadequategtogmaintaingvitalgorgans.gThegnursegdoesghavegtogbegc
oncernedgaboutgperfusion.gPerfusiongisgnotgonlygmonitoredgbygthegphysiciangbutgthegnursegtoo.g
Perfusiongdoesgnotgalwaysgchangegasgthegpersongages.g
7.gThegnursegisgconductinggagpatientgassessment.gThegpatientgtellsgthegnursegthatgheghasgsmokedgt
wogpacksgofgcigarettesgpergdaygforg27gyears.gThegnursegmaygfindgwhichgdatagupongassessment?g
a. Bloodgpressuregabovegthegnormalgrangeg
b. Boundinggpedalgpulsesg
c. Nightgblindnessg
d. Refluxgdiseaseg
ANS:gAg
Smokersghavegagconstrictiongofgthegbloodgvesselsgduegtogthegtargandgnicotinegingcigarettes.gThisg
constrictiongmaygleadgtoghypertension.gBoundinggpulses,gnightgblindness,gandgrefluxgdiseasegdog
notghavegagdirectglinkgtogsmoking.g
g
g
g
g
g
g
g
g
g
Chapterg2.GasgExchangeg
g
MULTIPLEgCHOICEg
1. Thegnursegisgassignedgaggroupgofgpatients.gWhichgpatientgwouldgthegnursegidentifygasgbei
nggatgincreasedgriskgforgimpairedggasgexchange?gAgpatientg
a. withgagbloodgglucosegofg350gmg/dLg
b. whoghasgbeengonganticoagulantsgforg10gdaysg
c. withgaghemoglobingofg8.5gg/dLg
d. withgagheartgrategofg100gbeats/mingandgbloodgpressuregofg100/60g
ANS:gCg
Theghemoglobingisglowg(anemia),gthereforegthegabilitygofgthegbloodgtogcarrygoxygengisgdecreased
.g
Highgbloodgglucosegand/organticoagulantsgdognotgaltergthegoxygengcarryinggcapacitygofgthegbloo
d.gAgheartgrategofg100gbeats/mingandgbloodgpressuregofg100/60garegnotgindicativegofgoxygengcarr
yinggcapacitygofgthegblood.g
2. Thegnursegisgreviewinggthegpatientsgarterialgbloodggasgresults.gThegPaO2gisg96gmmgHg,gp
Hgisg7.20,gPaCO2gisg55gmmgHg,gandgHCO3gisg25gmEq/L.gWhatgwouldgthegnursegexpectgtogobse
rvegongassessmentgofgthisgpatient?g
g
MEDCONNOISSEURLIBRARIES.COMg
g
g
g
MEDCONNOISSEURLIBRARIES.COMg
g
, MEDCONNOISSEURLIBRARIES.COMg
g
ClinicalgReasoninggCasesgingNursingg7thgEditiongHardinggSnydergTestgBankg
g
Chapterg1.gPerfusiong
g
MULTIPLEgCHOICEg
1. Thegnursegisgexplaininggtogagstudentgnursegaboutgimpairedgcentralgperfusion.gThegnursegk
nowsgthegstudentgunderstandsgthisgproblemgwhengthegstudentgstates,gCentralgperfusiong
a. isgmonitoredgonlygbygthegphysician.g
b. involvesgthegentiregbody.g
c. isgdecreasedgwithghypertension.g
d. isgtoxicgtogthegcardiacgsystem.g
ANS:gBg
Centralgperfusiongdoesginvolvegthegentiregbodygasgallgorgansgaregsuppliedgwithgoxygengandgvitalg
nutrients.gThegphysiciangdoesgnotgcontrolgthegbodysgabilitygforgperfusion.gCentralgperfusiongisgn
otgdecreasedgwithghypertension.gCentralgperfusiongisgnotgtoxicgtogthegcardiacgsystem.g
2. Agpatientgwasgdiagnosedgwithghypertension.gThegpatientgasksgthegnurseghowgthisgdisease
gcouldghaveghappenedgtogthem.gThegnursesgbestgresponsegisgHypertensiong
a. happensgtogeveryonegsoonergorglater.gDontgbegconcernedgaboutgit.g
b. canghappengfromgeatinggagpoorgdiet,gsogchangegwhatgyougaregeating.g
c. canghappengfromgarterialgchangesgthatgimpedegthegbloodgflow.g
d. happensgwhengpeoplegdognotgexercise,gsogyougshouldgwalkgeverygday.g
ANS:gCg
Hardeninggofgthegarteriesgfromgatherosclerosisgcangcauseghypertensiongingthegpatient.g
Hypertensiongdoesgnotghappengtogeveryone.gChanginggthegpatientsgdietgandgexercisinggmaygbegag
positiveglifegchange,gbutgtheseganswersgdognotgexplaingtogthegpatientghowgthegdiseasegcouldghave
ghappened.g
3. Thegpatientgasksgthegnursegtogexplaingthegsinoatrialgnodegingthegheart.gThegnursesgbestgre
sponsegwouldgbe,gThegsinoatrialgnodeg
a. providesgthegheartgwithgthegstimulationgtogbeatgingagnormalgrhythm.g
b. protectsgthegheartgfromgatheroscleroticgchanges.g
c. providesgthegheartgwithgoxygenatedgblood.g
d. protectsgthegheartgfromginfection.g
g
MEDCONNOISSEURLIBRARIES.COMg
g
, MEDCONNOISSEURLIBRARIES.COMg
g
ANS:gAg
Thegsinoatrialgnodegisgthegnaturalgpacemakergofgthegheart,gandgitgassistsgthegheartgtogbeatgingag
normalgrhythm.gThegsinoatrialgnodegdoesgnotgprotectgfromgatheroscleroticgchangesgorginfection,g
andgitgdoesgnotgdirectlygprovidegthegheartgwithgoxygenatedgblood.g
4. Thegpatientgisgbroughtgtogthegemergencygdepartmentgaftergagmotorgvehiclegaccident.gTheg
patientgisgdiagnosedgwithginternalgbleeding.gThegnursesgprimarygconcerngisgtogmonitorgforg
a. mentalgalertness.g
b. perfusion.g
c. pain.g
d. reactiongtogmedications.g
ANS:gBg
Perfusiongisgthegcorrectganswer,gbecausegwithginternalgbleeding,gthegnursegshouldgmonitorgvit
algsignsgtogbegsuregperfusiongisghappening.gMentalgalertness,gpain,gandgmedicationgreactionsg
aregimportantgbutgnotgthegprimarygconcern.g
5. Agpatientsgserumgelectrolytesgaregbeinggmonitored.gThegnursegnoticesgthatgthegpotassium
glevelgisglow.gThegnursegknowsgthatgthegpatientgshouldgbegobservedgforg
a. tissuegischemia.g
b. braingmalformations.g
c. intestinalgblockage.g
d. cardiacgdysthymia.g
ANS:gDg
Cardiacgdysthymiagisgagpossibilitygwhengserumgpotassiumgisghighgorglow.gTissuegischemia,gbrain
gmalformations,gorgintestinalgblockagegdognotghavegagdirectgcorrelationgtogpotassiumgirregularitie
s.g6.gAgnursegisgexplaininggtogagstudentgnursegaboutgperfusion.gThegnursegknowsgthegstudentgund
erstandsgthegconceptgofgperfusiongwhengthegstudentgstates,gPerfusiong
a. isgagnormalgfunctiongofgthegbody,gandgIgdontghavegtogbegconcernedgaboutgit.
g
b. isgmonitoredgbygthegphysician,gandgIgjustgfollowgorders.g
c. isgmonitoredgbygvitalgsignsgandgcapillarygrefill.g
d. variesgasgagpersongages,gsogIgwouldgexpectgchangesgingthegbody.g
ANS:gCg
g
MEDCONNOISSEURLIBRARIES.COMg
g
, MEDCONNOISSEURLIBRARIES.COMg
g
Thegbestgmethodgtogmonitorgperfusiongisgtogmonitorgvitalgsignsgandgcapillarygrefill.gThisgallowsgt
hegnursegtogknowgifgperfusiongisgadequategtogmaintaingvitalgorgans.gThegnursegdoesghavegtogbegc
oncernedgaboutgperfusion.gPerfusiongisgnotgonlygmonitoredgbygthegphysiciangbutgthegnursegtoo.g
Perfusiongdoesgnotgalwaysgchangegasgthegpersongages.g
7.gThegnursegisgconductinggagpatientgassessment.gThegpatientgtellsgthegnursegthatgheghasgsmokedgt
wogpacksgofgcigarettesgpergdaygforg27gyears.gThegnursegmaygfindgwhichgdatagupongassessment?g
a. Bloodgpressuregabovegthegnormalgrangeg
b. Boundinggpedalgpulsesg
c. Nightgblindnessg
d. Refluxgdiseaseg
ANS:gAg
Smokersghavegagconstrictiongofgthegbloodgvesselsgduegtogthegtargandgnicotinegingcigarettes.gThisg
constrictiongmaygleadgtoghypertension.gBoundinggpulses,gnightgblindness,gandgrefluxgdiseasegdog
notghavegagdirectglinkgtogsmoking.g
g
g
g
g
g
g
g
g
g
Chapterg2.GasgExchangeg
g
MULTIPLEgCHOICEg
1. Thegnursegisgassignedgaggroupgofgpatients.gWhichgpatientgwouldgthegnursegidentifygasgbei
nggatgincreasedgriskgforgimpairedggasgexchange?gAgpatientg
a. withgagbloodgglucosegofg350gmg/dLg
b. whoghasgbeengonganticoagulantsgforg10gdaysg
c. withgaghemoglobingofg8.5gg/dLg
d. withgagheartgrategofg100gbeats/mingandgbloodgpressuregofg100/60g
ANS:gCg
Theghemoglobingisglowg(anemia),gthereforegthegabilitygofgthegbloodgtogcarrygoxygengisgdecreased
.g
Highgbloodgglucosegand/organticoagulantsgdognotgaltergthegoxygengcarryinggcapacitygofgthegbloo
d.gAgheartgrategofg100gbeats/mingandgbloodgpressuregofg100/60garegnotgindicativegofgoxygengcarr
yinggcapacitygofgthegblood.g
2. Thegnursegisgreviewinggthegpatientsgarterialgbloodggasgresults.gThegPaO2gisg96gmmgHg,gp
Hgisg7.20,gPaCO2gisg55gmmgHg,gandgHCO3gisg25gmEq/L.gWhatgwouldgthegnursegexpectgtogobse
rvegongassessmentgofgthisgpatient?g
g
MEDCONNOISSEURLIBRARIES.COMg
g
