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Exam (elaborations) nursing Skills in Clinical Nursing, ISBN: 9781488620690

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improve your grade and skills in nursing

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A patient is experiencing impaired circulation secondary to increased
systemic arterial pressure. Which of the following statements is the most
relevant phenomenon?
Question 1 options:
Increased preload due to vascular resistance
High afterload because of backpressure against the left ventricle


Impaired contractility due to aortic resistance
Systolic impairment because of arterial stenosis

Question 2 (2 points)
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A nurse practitioner employed in a hospitalist notices that a patient is
experiencing muscle atrophy following 2 weeks in traction after a motor
vehicle accident. Which of the following factors has most likely contributed
to the atrophy of the patient's muscle cells?
Question 2 options:
High levels of insulin and IGF-1 in the patient's blood during immobilization
Denervation of the affected muscles during the time of traction

A reduction of skeletal muscle use secondary to the traction treatment


Reduced oxygen consumption and cellular function that ensures muscle cell survival

Question 3 (2 points)
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An older adult female patient has presented with a new onset of shortness of
breath, and the patient's nurse practitioner has ordered measurement of her
BNP levels along with other diagnostic tests. What is the most accurate
rationale for the nurse practitioner's choice of blood work?
Question 3 options:
BNP is released as a compensatory mechanism during heart failure and measuring it c
help differentiate the patient's dyspnea from a respiratory pathology.
BNP is an indirect indicator of the effectiveness of the RAA system in compensating
for heart failure.
BNP levels correlate with the patient's risk of developing cognitive deficits
secondary to heart failure and consequent brain hypoxia.
BNP becomes elevated in cases of cardiac asthma, Cheyne-Stokes respirations, and
acute pulmonary edema, and measurement can gauge the severity of pulmonary effects.

Question 4 (2 points)

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A nurse practitioner 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?
Question 4 options:
“I could come down with viral or bacterial pneumonia as a result of a bad flu bug.”
“I know my vaccination is especially important since there aren't any drugs that ca
treat the flu once I get sick with it.”
“The emphasis on bundling up, staying warm, and drinking lots of fluids is outdated
and actually ineffective.”
“Like all vaccines, it is ideal if everyone in a population gets immunized against
the flu.”

Question 5 (2 points)
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A 71-year-old woman is dependent on oxygen therapy and bronchodilators due
to her diagnosis of emphysema. Which of the following processes would her
care team be most justified in ruling out?
Question 5 options:
Decreased elastic recoil due to alveolar damage
Decreased residual lung volume due to impaired alveolar ventilation


Increased anatomic dead space due to reduced tidal volume
Increased alveolar dead space due to incorrect intrapleural pressure


Question 6 (2 points)
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A 66-year-old patient's echocardiogram reveals a hypertrophied left
ventricle, normal chamber volume, and a normal ejection fraction from the
heart. What is this patient's most likely diagnosis?
Question 6 options:
Mitral valve regurgitation
Aortic valve stenosis
Mitral valve stenosis
Aortic valve regurgitation

Question 7 (2 points)
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, Which of the following statements most accurately conveys an aspect of
lymphatic system activity?
Question 7 options:
B and T lymphocyte development begins in the bone marrow and ends in the peripheral lymp


B cells and macrophages are released from the bone marrow in their completed state.
Stem cells in the lymph nodes initiate and regulate the process of white cell
synthesis.
Leukocytes bypass vascular circulation and are distributed instead by the lymphatic
system.
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Question 8 (2 points)
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An 81-year-old male resident of a long-term care facility has a long-
standing diagnosis of heart failure. Which of the following short-term and
longer-term compensatory mechanisms is least likely to decrease the symptoms
of his heart failure?
Question 8 options:
An increase in preload via the Frank-Starling mechanism
Sympathetic stimulation and increased serum levels of epinephrine and norepinephrin
Activation of the renin-angiotensin-aldosterone (RAA) system and secretion of brain
natriuretic peptide (BNP)
AV node pacemaking activity and vagal nerve suppression

Question 9 (2 points)
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A nurse practitioner student is familiarizing herself with the overnight
admissions to an acute medical unit of a university hospital. Which of the
following patients would the student recognize as being least likely to have
a diagnosis of antiphospholipid syndrome in his or her medical history?
Question 9 options:
A 66-year-old obese male with left-sided hemiplegia secondary to a cerebrovascular
accident
A 90-year-old female resident of a long-term care facility who has been experiencin
transient ischemic attacks
A 30-year-old female with a diagnosis of left leg DVT and a pulmonary embolism

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