PCHA EVALUATION EXAM LATEST QUESTIONS AND
ANSWERS SURE A+
✔✔A patient is being seen in the clinic for "fainting episodes". The patient has a blood
pressure of 150/90 in a lying position, 120/80 in a sitting position, and 90/60 in a
standing position. How should the nurse interpret these findings? - ✔✔The change in
blood pressure readings is called orthostatic hypotension.
✔✔In the article by Rakotz, 'Medical students and measuring blood pressure: Results
from the American Medical Association Blood Pressure Check Challenge', what are the
consequences of poor technique when measuring blood pressure? - ✔✔all of the above
- A 5- to 10-mm Hg error can result in an incorrect diagnosis of hypertension.
- Poor technique can cause patients with hypertension that is controlled to appear
uncontrolled.
- Without accurate blood pressure readings, improving blood pressure control in unlikely
because physicians will not reliably know which patients need to be more aggressively
treated and which do not.
✔✔Which of the following is correct about arterial blood pressure? - ✔✔It is important to
know the normal blood pressure of each individual.
✔✔The nurse has just admitted the patient for evaluation of unexplained fever. The
patient's temperature is 102o F, blood pressure 76/50 (baseline 130/74), pulse 110 bpm
(baseline 72), respiration 16 bpm (baseline 12). Which of the following best explains the
patient's hypotension? - ✔✔Vasodilation secondary to his illness.
✔✔Which of the following is NOT true regarding assessment of the respiratory system?
- ✔✔Orthopnea refers to a subjective feeling of not being able to get enough oxygen
while standing.
✔✔The patient is a 85-years-old and has come to your clinic with complaints of fatigue,
cough and decreased appetite for 3 days. When taking vital signs on this client, you
note the oral temperature to be 99.3o F. You should: - ✔✔consider this a concerning
finding which needs attention
✔✔According to the article by Kiekkas, et al., 'Physical Antipyresis in Critically Ill Adults',
what is the benefit of temperature elevation? - ✔✔inhibits bacterial growth
✔✔In the article by Cretikos, et al., 'Respiratory rate: The neglected vital sign', a patient
with a respiratory rate of over 24 breaths/minute should be monitored more closely,
even if other vital signs are normal. - ✔✔true
✔✔Which of the following is true with regard to using the temporal artery thermometer?
- ✔✔Measure only the 'up' or exposed side for the most accurate reading.
, ✔✔The patient is admitted to the hospital after a three day history of severe vomiting
and diarrhea secondary to a bacterial infection of the colon. The patient is otherwise in
good health with no chronic illnesses. The baseline blood pressure is 130/84, pulse 78.
During the admission assessment, what might the nurse expect the patient's vital signs
to be based on the illness? (All blood pressures taken in the supine (lying) position). -
✔✔Pulse: 130, Blood Pressure: 90/50, Resp: 24, Temp: 102°F
✔✔The nurse is observing a student who is listening to a patient's lungs. Which action
by the student indicates a need to review respiratory assessment skills? - ✔✔The
student auscultates over the scapulae.
✔✔Mrs. M. is admitted for pneumonia in her right middle lobe. Where would the
practitioner expect to auscultate decreased or adventitious breath sounds? - ✔✔On the
anterior and lateral chest, between the 4th and 6th ribs approximately, starting from the
midaxillary line to the right sternal border.
✔✔Your client has a long history of chronic obstructive pulmonary disease. Which of the
following are you most likely to observe? - ✔✔all of the above
- an anterior-posterior (AP) : transverse diameter ratio of 1:1.
- pursed lip breathing
- tripod position when sitting
✔✔A 25-year-old female college student comes to the Emergency Department after she
has fallen down the stairs. She has sudden, sharp pain on the right side of her chest
with shortness of breath. Thoracic expansion is asymmetrical, with little movement of
her right side. Her trachea is deviated toward the left side. She has hyperresonant
percussion sounds on the right chest and resonant sounds on the left chest. There are
no breath sounds heard on the right. This description is most consistent with: -
✔✔pneumothorax
✔✔Expected assessment findings in the normal adult lung include the presence of: -
✔✔resonant percussion tones over lung tissue and symmetrical thoracic expansion.
✔✔When auscultating the posterior lower lung lobes of the adult client, the practitioner
notes low pitched, soft breath sounds with inspiration being longer than expiration. The
practitioner knows that these are: - ✔✔vesicular breath sounds and are normal in that
location
✔✔Which of the following techniques is appropriate during auscultation of breath
sounds? - ✔✔Listen to at least one full respiration (inspiration and expiration) in each
location.
✔✔The angle of Louis: - ✔✔is a landmark used to mark tracheal bifurcation anteriorly.
ANSWERS SURE A+
✔✔A patient is being seen in the clinic for "fainting episodes". The patient has a blood
pressure of 150/90 in a lying position, 120/80 in a sitting position, and 90/60 in a
standing position. How should the nurse interpret these findings? - ✔✔The change in
blood pressure readings is called orthostatic hypotension.
✔✔In the article by Rakotz, 'Medical students and measuring blood pressure: Results
from the American Medical Association Blood Pressure Check Challenge', what are the
consequences of poor technique when measuring blood pressure? - ✔✔all of the above
- A 5- to 10-mm Hg error can result in an incorrect diagnosis of hypertension.
- Poor technique can cause patients with hypertension that is controlled to appear
uncontrolled.
- Without accurate blood pressure readings, improving blood pressure control in unlikely
because physicians will not reliably know which patients need to be more aggressively
treated and which do not.
✔✔Which of the following is correct about arterial blood pressure? - ✔✔It is important to
know the normal blood pressure of each individual.
✔✔The nurse has just admitted the patient for evaluation of unexplained fever. The
patient's temperature is 102o F, blood pressure 76/50 (baseline 130/74), pulse 110 bpm
(baseline 72), respiration 16 bpm (baseline 12). Which of the following best explains the
patient's hypotension? - ✔✔Vasodilation secondary to his illness.
✔✔Which of the following is NOT true regarding assessment of the respiratory system?
- ✔✔Orthopnea refers to a subjective feeling of not being able to get enough oxygen
while standing.
✔✔The patient is a 85-years-old and has come to your clinic with complaints of fatigue,
cough and decreased appetite for 3 days. When taking vital signs on this client, you
note the oral temperature to be 99.3o F. You should: - ✔✔consider this a concerning
finding which needs attention
✔✔According to the article by Kiekkas, et al., 'Physical Antipyresis in Critically Ill Adults',
what is the benefit of temperature elevation? - ✔✔inhibits bacterial growth
✔✔In the article by Cretikos, et al., 'Respiratory rate: The neglected vital sign', a patient
with a respiratory rate of over 24 breaths/minute should be monitored more closely,
even if other vital signs are normal. - ✔✔true
✔✔Which of the following is true with regard to using the temporal artery thermometer?
- ✔✔Measure only the 'up' or exposed side for the most accurate reading.
, ✔✔The patient is admitted to the hospital after a three day history of severe vomiting
and diarrhea secondary to a bacterial infection of the colon. The patient is otherwise in
good health with no chronic illnesses. The baseline blood pressure is 130/84, pulse 78.
During the admission assessment, what might the nurse expect the patient's vital signs
to be based on the illness? (All blood pressures taken in the supine (lying) position). -
✔✔Pulse: 130, Blood Pressure: 90/50, Resp: 24, Temp: 102°F
✔✔The nurse is observing a student who is listening to a patient's lungs. Which action
by the student indicates a need to review respiratory assessment skills? - ✔✔The
student auscultates over the scapulae.
✔✔Mrs. M. is admitted for pneumonia in her right middle lobe. Where would the
practitioner expect to auscultate decreased or adventitious breath sounds? - ✔✔On the
anterior and lateral chest, between the 4th and 6th ribs approximately, starting from the
midaxillary line to the right sternal border.
✔✔Your client has a long history of chronic obstructive pulmonary disease. Which of the
following are you most likely to observe? - ✔✔all of the above
- an anterior-posterior (AP) : transverse diameter ratio of 1:1.
- pursed lip breathing
- tripod position when sitting
✔✔A 25-year-old female college student comes to the Emergency Department after she
has fallen down the stairs. She has sudden, sharp pain on the right side of her chest
with shortness of breath. Thoracic expansion is asymmetrical, with little movement of
her right side. Her trachea is deviated toward the left side. She has hyperresonant
percussion sounds on the right chest and resonant sounds on the left chest. There are
no breath sounds heard on the right. This description is most consistent with: -
✔✔pneumothorax
✔✔Expected assessment findings in the normal adult lung include the presence of: -
✔✔resonant percussion tones over lung tissue and symmetrical thoracic expansion.
✔✔When auscultating the posterior lower lung lobes of the adult client, the practitioner
notes low pitched, soft breath sounds with inspiration being longer than expiration. The
practitioner knows that these are: - ✔✔vesicular breath sounds and are normal in that
location
✔✔Which of the following techniques is appropriate during auscultation of breath
sounds? - ✔✔Listen to at least one full respiration (inspiration and expiration) in each
location.
✔✔The angle of Louis: - ✔✔is a landmark used to mark tracheal bifurcation anteriorly.
