TEST BANK t
CLINICAL REASONING CASES
t t
tIN NURSING,t
7TH EDITION
t
BY HARDING| SNYDER
t t
TEST BANK t
,Chapter 1. Perfusion t t
Clinical Reasoning Cases in Nursing 7th Edition Harding Snyder Test Bank
t t t t t t t t t t
MULTIPLE CHOICE t
1. The nurse is explaining to a student nurse about impaired central perfusion. The nurse knows the
t t t t t t t t t t t t t t t t
student understands this problem when the student states, Central perfusion
t t t t t t t t t t
a. Is monitored only by the physician. t t t t t
b. Involves the entire body. t t t
c. Is decreased with hypertension.
t t t
d. Is toxic to the cardiac system.
t t t t t
ANS: B t
Central perfusion does involve the entire body as all organs are supplied with oxygen and vital
t t t t t t t t t t t t t t t
Nutrients. The physician does not control the bodys ability for perfusion. Central perfusion is not
t t t t t t t t t t t t t t t
decreased with hypertension. Central perfusion is not toxic to the cardiac system.
t t t t t t t t t t t t
2. A patient was diagnosed with hypertension. The patient asks the nurse how this disease could
t t t t t t t t t t t t t t t
have happened to them. The nurses best response is Hypertension
t t t t t t t t t t
a. Happens to everyone sooner or later. Dont be concerned about it. t t t t t t t t t t
b. Can happen from eating a poor diet, so change what you are eating.
t t t t t t t t t t t t
c. Can happen from arterial changes that impede the blood flow.
t t t t t t t t t
d. Happens when people do not exercise, so you should walk every t t t t t t t t t t
day.
t
ANS: C t
Hardening of the arteries from atherosclerosis can cause hypertension in the patient. Hypertension
t t t t t t t t t t t t
does not happen to everyone. Changing the patients diet and exercising may be a positive life
t t t t t t t t t t t t t t t t
change, but these answers do not explain to the patient how the disease could have happened.
t t t t t t t t t t t t t t t t
3. The patient asks the nurse to explain the sinoatrial node in the heart. The nurses best response
t t t t t t t t t t t t t t t t t
would be, The sinoatrial node
t t t t t
a. Provides the heart with the stimulation to beat in a normal rhythm. t t t t t t t t t t t
b. Protects the heart from atherosclerotic changes. t t t t t
c. Provides the heart with oxygenated blood. t t t t t
d. Protects the heart from t t t
infection.
t
ANS: A t
The sinoatrial node is the natural pacemaker of the heart, and it assists the heart to beat in a
t t t t t t t t t t t t t t t t t t
Normal rhythm. The sinoatrial node does not protect from atherosclerotic changes or
t t t t t t t t t t t t
infection, and it does not directly provide the heart with oxygenated blood.
t t t t t t t t t t t t
4. The patient is brought to the emergency department after a motor vehicle accident. The patient is
t t t t t t t t t t t t t t t t
diagnosed with internal bleeding. The nurses primary concern is to monitor for
t t t t t t t t t t t t
a. Mental alertness. t
b. Perfusion.
, c. Pain.
d. Reaction to t
medications. ANS: B
t t t
Perfusion is the correct answer, because with internal bleeding, the nurse should monitor vital
t t t t t t t t t t t t t
Signs to be sure perfusion is happening. Mental alertness, pain, and medication reactions are
t t t t t t t t t t t t t
important but not the primary concern.
t t t t t t
5. A patients serum electrolytes are being monitored. The nurse notices that the potassium level is
t t t t t t t t t t t t t t t
low. The nurse knows that the patient should be observed for
t t t t t t t t t t t
a. Tissue ischemia. t
b. Brain malformations. t
c. Intestinal blockage. t
d. Cardiac
dysthymia.
t
ANS: D t
Cardiac dysthymia is a possibility when serum potassium is high or low. Tissue ischemia, brain
t t t t t t t t t t t t t t
Malformations, or intestinal blockage do not have a direct correlation to potassium irregularities.
t t t t t t t t t t t t t
6. A nurse is explaining to a student nurse about perfusion. The nurse knows the student
t t t t t t t t t t t t t t t
understands the concept of perfusion when the student states, Perfusion
t t t t t t t t t t
a. Is a normal function of the body, and I dont have to be concerned about it.
t t t t t t t t t t t t t t t
b. Is monitored by the physician, and I just follow orders.
t t t t t t t t t
c. Is monitored by vital signs and capillary refill.
t t t t t t t
d. Varies as a person ages, so I would expect changes in the t t t t t t t t t t t
body.
t
ANS: C t
The best method to monitor perfusion is to monitor vital signs and capillary refill. This allows
t t t t t t t t t t t t t t t
The nurse to know if perfusion is adequate to maintain vital organs. The nurse does have to be
t t t t t t t t t t t t t t t t t t
concerned about perfusion. Perfusion is not only monitored by the physician but the nurse too.
t t t t t t t t t t t t t t t
Perfusion does not always change as the person ages.
t t t t t t t t t
7. The nurse is conducting a patient assessment. The patient tells the nurse that he has smoked
t t t t t t t t t t t t t t t t
two packs of cigarettes per day for 27 years. The nurse may find which data upon assessment?
t t t t t t t t t t t t t t t t t
a. Blood pressure above the normal range t t t t t
b. Bounding pedal pulses t t
c. Night blindness t
d. Reflux disease t
e. ANS: A t
Smokers have a constriction of the blood vessels due to the tar and nicotine in cigarettes. This
t t t t t t t t t t t t t t t t
Constriction may lead to hypertension. Bounding pulses, night blindness, and reflux disease do
t t t t t t t t t t t t t
not have a direct link to smoking.
t t t t t t t
, Chapter 2.Gas Exchange t t
MULTIPLE CHOICE
t t
1. The nurse is assigned a group of patients. Which patient would the nurse identify as being at
t t t t t t t t t t t t t t t t t
increased risk for impaired gas exchange? A patient
t t t t t t t t
a. With a blood glucose of 350 mg/dl t t t t t t
b. Who has been on anticoagulants for 10 days
t t t t t t t
c. With a hemoglobin of 8.5 g/dl t t t t t
d. With a heart rate of 100 beats/min and blood pressure of
t t t t t t t t t t
100/60
t
ANS: C t
The hemoglobin is low (anemia), therefore the ability of the blood to carry oxygen is decreased.
t t t t t t t t t t t t t t t
High blood glucose and/or anticoagulants do not alter the oxygen carrying capacity of the blood. A
t t t t t t t t t t t t t t t t
heart rate of 100 beats/min and blood pressure of 100/60 are not indicative of oxygen carrying
t t t t t t t t t t t t t t t t
capacity of the blood.
t t t t
2. The nurse is reviewing the patients arterial blood gas results. The pao2 is 96 mm Hg, ph is
t t t t t t t t t t t t t t t t t t
7.20, paco2 is 55 mm Hg, and HCO3 is 25 meq/L. What would the nurse expect to observe on
t t t t t t t t t t t t t t t t t t
assessment of this patient?
t t t t
a. Disorientation and tremors t t
b. Tachycardia and decreased blood pressure t t t t
c. Increased anxiety and irritability t t t
d. Hyperventilation and lethargy t t
ANS: A t
The patient is experiencing respiratory acidosis ( ph, and paco2 ) which may be manifested by
t t t t t t t t t t t t t t t
disorientation, tremors, possible seizures, and decreased level of consciousness.
t t t t t t t t t
tTachycardia and decreased blood pressure are not characteristic of a problem of respiratory
t t t t t t t t t t t t
acidosis.
t
Increased anxiety and hyperventilation will cause respiratory alkalosis, which is manifested by an
t t t t t t t t t t t t
increase in ph and a decrease in paco2.
t t t t t t t t
3. The nurse would identify which patient as having a problem of impaired gas exchange secondary
t t t t t t t t t t t t t t t
to a perfusion problem? A patient with
t t t t t t t
a. Peripheral arterial disease of the lower extremities t t t t t t
b. Chronic obstructive pulmonary disease (COPD) t t t t
c. Chronic asthma t
CLINICAL REASONING CASES
t t
tIN NURSING,t
7TH EDITION
t
BY HARDING| SNYDER
t t
TEST BANK t
,Chapter 1. Perfusion t t
Clinical Reasoning Cases in Nursing 7th Edition Harding Snyder Test Bank
t t t t t t t t t t
MULTIPLE CHOICE t
1. The nurse is explaining to a student nurse about impaired central perfusion. The nurse knows the
t t t t t t t t t t t t t t t t
student understands this problem when the student states, Central perfusion
t t t t t t t t t t
a. Is monitored only by the physician. t t t t t
b. Involves the entire body. t t t
c. Is decreased with hypertension.
t t t
d. Is toxic to the cardiac system.
t t t t t
ANS: B t
Central perfusion does involve the entire body as all organs are supplied with oxygen and vital
t t t t t t t t t t t t t t t
Nutrients. The physician does not control the bodys ability for perfusion. Central perfusion is not
t t t t t t t t t t t t t t t
decreased with hypertension. Central perfusion is not toxic to the cardiac system.
t t t t t t t t t t t t
2. A patient was diagnosed with hypertension. The patient asks the nurse how this disease could
t t t t t t t t t t t t t t t
have happened to them. The nurses best response is Hypertension
t t t t t t t t t t
a. Happens to everyone sooner or later. Dont be concerned about it. t t t t t t t t t t
b. Can happen from eating a poor diet, so change what you are eating.
t t t t t t t t t t t t
c. Can happen from arterial changes that impede the blood flow.
t t t t t t t t t
d. Happens when people do not exercise, so you should walk every t t t t t t t t t t
day.
t
ANS: C t
Hardening of the arteries from atherosclerosis can cause hypertension in the patient. Hypertension
t t t t t t t t t t t t
does not happen to everyone. Changing the patients diet and exercising may be a positive life
t t t t t t t t t t t t t t t t
change, but these answers do not explain to the patient how the disease could have happened.
t t t t t t t t t t t t t t t t
3. The patient asks the nurse to explain the sinoatrial node in the heart. The nurses best response
t t t t t t t t t t t t t t t t t
would be, The sinoatrial node
t t t t t
a. Provides the heart with the stimulation to beat in a normal rhythm. t t t t t t t t t t t
b. Protects the heart from atherosclerotic changes. t t t t t
c. Provides the heart with oxygenated blood. t t t t t
d. Protects the heart from t t t
infection.
t
ANS: A t
The sinoatrial node is the natural pacemaker of the heart, and it assists the heart to beat in a
t t t t t t t t t t t t t t t t t t
Normal rhythm. The sinoatrial node does not protect from atherosclerotic changes or
t t t t t t t t t t t t
infection, and it does not directly provide the heart with oxygenated blood.
t t t t t t t t t t t t
4. The patient is brought to the emergency department after a motor vehicle accident. The patient is
t t t t t t t t t t t t t t t t
diagnosed with internal bleeding. The nurses primary concern is to monitor for
t t t t t t t t t t t t
a. Mental alertness. t
b. Perfusion.
, c. Pain.
d. Reaction to t
medications. ANS: B
t t t
Perfusion is the correct answer, because with internal bleeding, the nurse should monitor vital
t t t t t t t t t t t t t
Signs to be sure perfusion is happening. Mental alertness, pain, and medication reactions are
t t t t t t t t t t t t t
important but not the primary concern.
t t t t t t
5. A patients serum electrolytes are being monitored. The nurse notices that the potassium level is
t t t t t t t t t t t t t t t
low. The nurse knows that the patient should be observed for
t t t t t t t t t t t
a. Tissue ischemia. t
b. Brain malformations. t
c. Intestinal blockage. t
d. Cardiac
dysthymia.
t
ANS: D t
Cardiac dysthymia is a possibility when serum potassium is high or low. Tissue ischemia, brain
t t t t t t t t t t t t t t
Malformations, or intestinal blockage do not have a direct correlation to potassium irregularities.
t t t t t t t t t t t t t
6. A nurse is explaining to a student nurse about perfusion. The nurse knows the student
t t t t t t t t t t t t t t t
understands the concept of perfusion when the student states, Perfusion
t t t t t t t t t t
a. Is a normal function of the body, and I dont have to be concerned about it.
t t t t t t t t t t t t t t t
b. Is monitored by the physician, and I just follow orders.
t t t t t t t t t
c. Is monitored by vital signs and capillary refill.
t t t t t t t
d. Varies as a person ages, so I would expect changes in the t t t t t t t t t t t
body.
t
ANS: C t
The best method to monitor perfusion is to monitor vital signs and capillary refill. This allows
t t t t t t t t t t t t t t t
The nurse to know if perfusion is adequate to maintain vital organs. The nurse does have to be
t t t t t t t t t t t t t t t t t t
concerned about perfusion. Perfusion is not only monitored by the physician but the nurse too.
t t t t t t t t t t t t t t t
Perfusion does not always change as the person ages.
t t t t t t t t t
7. The nurse is conducting a patient assessment. The patient tells the nurse that he has smoked
t t t t t t t t t t t t t t t t
two packs of cigarettes per day for 27 years. The nurse may find which data upon assessment?
t t t t t t t t t t t t t t t t t
a. Blood pressure above the normal range t t t t t
b. Bounding pedal pulses t t
c. Night blindness t
d. Reflux disease t
e. ANS: A t
Smokers have a constriction of the blood vessels due to the tar and nicotine in cigarettes. This
t t t t t t t t t t t t t t t t
Constriction may lead to hypertension. Bounding pulses, night blindness, and reflux disease do
t t t t t t t t t t t t t
not have a direct link to smoking.
t t t t t t t
, Chapter 2.Gas Exchange t t
MULTIPLE CHOICE
t t
1. The nurse is assigned a group of patients. Which patient would the nurse identify as being at
t t t t t t t t t t t t t t t t t
increased risk for impaired gas exchange? A patient
t t t t t t t t
a. With a blood glucose of 350 mg/dl t t t t t t
b. Who has been on anticoagulants for 10 days
t t t t t t t
c. With a hemoglobin of 8.5 g/dl t t t t t
d. With a heart rate of 100 beats/min and blood pressure of
t t t t t t t t t t
100/60
t
ANS: C t
The hemoglobin is low (anemia), therefore the ability of the blood to carry oxygen is decreased.
t t t t t t t t t t t t t t t
High blood glucose and/or anticoagulants do not alter the oxygen carrying capacity of the blood. A
t t t t t t t t t t t t t t t t
heart rate of 100 beats/min and blood pressure of 100/60 are not indicative of oxygen carrying
t t t t t t t t t t t t t t t t
capacity of the blood.
t t t t
2. The nurse is reviewing the patients arterial blood gas results. The pao2 is 96 mm Hg, ph is
t t t t t t t t t t t t t t t t t t
7.20, paco2 is 55 mm Hg, and HCO3 is 25 meq/L. What would the nurse expect to observe on
t t t t t t t t t t t t t t t t t t
assessment of this patient?
t t t t
a. Disorientation and tremors t t
b. Tachycardia and decreased blood pressure t t t t
c. Increased anxiety and irritability t t t
d. Hyperventilation and lethargy t t
ANS: A t
The patient is experiencing respiratory acidosis ( ph, and paco2 ) which may be manifested by
t t t t t t t t t t t t t t t
disorientation, tremors, possible seizures, and decreased level of consciousness.
t t t t t t t t t
tTachycardia and decreased blood pressure are not characteristic of a problem of respiratory
t t t t t t t t t t t t
acidosis.
t
Increased anxiety and hyperventilation will cause respiratory alkalosis, which is manifested by an
t t t t t t t t t t t t
increase in ph and a decrease in paco2.
t t t t t t t t
3. The nurse would identify which patient as having a problem of impaired gas exchange secondary
t t t t t t t t t t t t t t t
to a perfusion problem? A patient with
t t t t t t t
a. Peripheral arterial disease of the lower extremities t t t t t t
b. Chronic obstructive pulmonary disease (COPD) t t t t
c. Chronic asthma t
