NR 509 WEEK 4 Midterm EXAM.LATEST UPDATE
1. A 25-year-old woman is in her fifth month of pregnancy has a blood pressure of 100/70 mmHg. In reviewing her previous exam the FNP notes that her blood pressure in
...
NR 509 WEEK 4 Midterm EXAM.LATEST UPDATE
1. A 25-year-old woman is in her fifth month of pregnancy has a blood pressure of 100/70 mmHg. In reviewing her previous exam the FNP notes that her blood pressure in her second month was 124/80 mmHg. When evaluating this change what does the FNP know to be true?
2. A 35-year-old man is seen in the clinic for an infection in his left foot. Which of these findings should the FNP expect to see during an assessment of this patient?
This is a result of peripheral vasodilatation and is an expected change.
Enlarged and tender inguinal nodes
The inguinal nodes in the groin drain most of the lymph of the lower extremities. With local inflammation,
7. During an assessment of an older adult the FNP should expect to notice which finding as normal physiologic change associated with aging process?
ANS: Peripheral blood vessels growing more rigid with age, producing a rise in systolic blood pressure
Peripheral blood vessels grow more rigid with age, resulting in a rise in systolic blood pressure. Aging produces progressive enlargement of the intramuscular calf veins, not atrophy. The other options are not correct
ANS: early clubbing.
the nodes in that
area become swollen and tender.
"Do you have any history of problems
with your heart?"
3. A 45-year-old man is in the
8. During an assessment the FNP uses the profile sign to detect
The nurse should use the profile sign (viewing the finger from the side) to detect early clubbing.
elevated pressure related
clinic for a routine physical. During history the patient states he has been having difficulty sleeping. I'll be sleeping great and then I wake up and feel like I can't catch my
claudication
to heart failure
9. The findings from an assessment of a 70-year- old patient with swelling in his ankles include jugular venous pulsations
breath. The FNP's best response
to this would be
4. A 67-year-old patient states that he "recently began have pain in his left calf when climbing the 10 stairs to his
5 cm above the sternal angle when the head of his bed is elevated 45 degrees. The nurse knows that this finding indicates:
The presence of palpable lymph nodes
Lymph nodes are
relatively large in
apartment". This pain is relieved by sitting for about two minutes then he's able to resume activities. The FNP interprets this patient is most likely experiencing
5. The component of the conduction system referred to as the pacemaker of the heart is the
6. The direction of blood flow through the heart is best described by which of these
SA Node
Right atrium → right ventricle → pulmonary artery
→ lungs → pulmonary vein → left atrium
→ left ventricle
10. The FNP is examining the lymphatic system of a healthy three year old child. Which finding should the FNP expect?
11. The FNP is performing an assessment on an adult. The adults vital signs are normal and capillary refill is five seconds. What should the FNP do next?
children, and the superficial ones often are palpable even when the child is healthy.
ANS: Consider this a delayed capillary refill time and investigate further.
Normal capillary refill time is less than 1 to 2 seconds. The following conditions can skew the findings: a cool room, decreased body temperature, cigarette
smoking, peripheral edema, and anemia.
12. The FNP is preparing to perform modified Allen test. Which is an appropriate reason for this test?
ANS: To evaluate the adequacy of collateral circulation before cannulating the radial artery
A modified Allen test is used to evaluate the adequacy of collateral circulation before the radial artery is cannulated. The other responses are not reasons for a modified Allen test.
Increase in systolic
18. A patient complains of leg pain that wakes him at night. He states that he "has been having problems" with his legs. He has pain in his legs when they are elevated that disappears when he dangles them. He recently noticed "a sore" on the inner aspect of the right ankle. On the basis of this history information, the nurse interprets that the patient is most likely experiencing:
ANS: problems related to arterial insufficiency.
Night leg pain is common in aging adults. It may indicate the ischemic rest pain of peripheral vascular disease. Alterations in arterial circulation cause pain that becomes worse with leg elevation and is eased when the extremity is dangled.
pericardium
blood pressure
13. In assessing a 70-year-old man the FNP finds the following blood pressure 140/100 mmHg, heart rate 104 and slightly irregular, split S2. Which of these findings can... by expected hemodynamic changes related to age?
14. In assessing a patient's major risk factors for heart disease which would the FNP want to include when taking a history?
15. In assessing the carotid artery's of an older patient with cardiovascular disease, the FNP would
16. The mother of a three month old infant states that her baby has not been gaining weight. With further questioning the FNP finds that the infant falls asleep after nursing and wakes up after a short amount of time hungry again. What other information with the FNP want to have?
17. The nurse is assessing the pulses of a patient who has been admitted for untreated hyperthyroidism. The nurse should expect to find a(n)
pulse.
Smoking, hypertension, obesity, diabetes, high cholesterol
listen with the bell of the stethoscope to assess for bruits.
Presence of dyspnea of diaphoresis when sucking
ANS: bounding
A full, bounding pulse occurs with hyperkinetic states (such as exercise, anxiety, fever), anemia, and hyperthyroidism.
Absent pulse occurs with occlusion. Weak, thready pulses occur with shock and peripheral artery
19. The sack that surrounds and protects the heart is called the
20. Teh nurse is reviewing anatomy and physiology of the heart. Which statement best describes what is meant by atrial kick?
21. When assessing a newborn infant who is five minutes old the FNP knows that which of these statements would be true?
a.The left ventricle is larger and weighs more than the right ventricle.
b.The circulation of a newborn is identical to that of an adult.
c.Blood can flow into the left side of the heart through an opening in the atrial septum.
d.The foramen ovale closes just minutes before birth, and the ductus arteriosus closes immediately after.
22. When assessing a patient the FNP notes that the
The atria contract toward the end of diastole and push the remaining blood into the ventricles
c.Blood can flow into the left side of the heart through an opening in the atrial septum.
First, about two thirds of the blood is shunted through an opening in the atrial septum, the foramen ovale into the left side of the heart, where it is pumped out through the aorta. The foramen ovale closes within the first hour because the pressure in the right side of the heart is now lower than in the left side.
ANS: Auscultate the site for a bruit.
If a pulse is weak or diminished at the femoral site, the nurse should auscultate for a bruit.
Presence of a bruit, or
turbulent blood flow, indicates partial
disease.
left femoral pulse as
diminished 1+/4+. What should the FNP do next?
occlusion. The other responses are not
correct.
23. When listening to heart sounds the FNP knows that the valve closures that can be heard best at the base of the heart are
24. When performing a peripheral vascular assessment on a patient the FNP is unable to palpate the ulnar pulses. The patient skin is warm and capillary refill is normal. The FNP should next
25. Which of these statements describes the closure of the valves in a normal cardiac cycle?
aortic and pulmonic
ANS: consider this a normal finding and proceed with the peripheral vascular evaluation.
It is not usually necessary to palpate the ulnar pulses. The ulnar pulses are often not palpable in the normal person. The other responses are not correct.
The tricuspid valve closes slightly later than the mitral valve
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