n n n n n n n n
nEdition byMariannM.Harding;
n n n n n
Chapter1- 15
n n n
,Clinical Reasoning Cases in Nursing 8th Edition HardingSnyder Test Bank
n n n n n n n n n n
Contents:
Chapter 1. Perfusion
n n
Chapter 2. Gas Exchange
n n n
Chapter 3. Mobility
n n
Chapter 4. Digestion
n n
Chapter 5. UrinaryElimination
n n n
Chapter6. Intracranial Regulation
n n n
Chapter7. Metabolism and Glucose Regulation
n n n n n
Chapter 8. Immunity
n n
Chapter 9. Cellular Regulation
n n n
Chapter 10. Tissue Integrity
n n n
Chapter 11. Cognition
n n
Chapter 12. Infection and Inflammation
n n n n
Chapter 13. Developmental
n n
Chapter 14. Reproductive
n n
Chapter 15. Mood, Stress, and Addiction
n n n n n
,Chapter 1. Perfusion n n
ClinicalReasoning Cases in Nursing 8th EditionHarding SnyderTestBank
n n n n n n n n n n
MULTIPLE CHOICE n
1. Thenurseis explaining to a student nurseabout impaired central perfusion. Thenurseknows the
n n n n n n n n n n n n n n n n
student understands this problem when the student states, Central perfusion
n n n n n n n n n n
a. Is monitored onlybythe physician. n n n n n
b. Involves the entirebody. n n n
c. Isdecreased withhypertension.
n n n
d. Is toxicto thecardiacsystem.
n n n n n
ANSWER:B n
Centralperfusiondoes involvetheentirebody as all organs aresuppliedwith oxygen andvital Nutrients.
n n n n n n n n n n n n n n n n
The physician does not control the bodys ability for perfusion. Central perfusion is notdecreased with
n n n n n n n n n n n n n n n
hypertension. Central perfusion is not toxic to the cardiac system.
n n n n n n n n n n
2. A patientwas diagnosed withhypertension. Thepatientasks thenursehow this diseasecould have
n n n n n n n n n n n n n n n n
happened to them. The nurses best response is Hypertension
n n n n n n n n n
a. Happens to everyonesooner or later. Dont beconcerned about it. n n n n n n n n n n
b. Canhappen from eating apoor diet, so change what you areeating.
n n n n n n n n n n n n
c. Canhappen fromarterial changes thatimpede the blood flow.
n n n n n n n n n
d. Happenswhenpeopledonotexercise,soyoushouldwalkevery day. n n n n n n n n n n n
ANSWER:C n
Hardening of the arteries from atherosclerosis can cause hypertension in the patient. Hypertension does
n n n n n n n n n n n n n
not happen to everyone. Changing the patients diet and exercising maybe a positive lifechange, but
n n n n n n n n n n n n n n n n n
these answers do not explain to the patient how the disease could have happened.
n n n n n n n n n n n n n n
3. Thepatient asks the nurse to explain the sinoatrial node in the heart. Thenurses best response would be,
n n n n n n n n n n n n n n n n n n n
The sinoatrial node
n n n
a. Provides theheart with thestimulation to beat in anormal rhythm. n n n n n n n n n n n
b. Protectstheheartfromatherosclerotic changes. n n n n n
c. Provides theheart with oxygenated blood. n n n n n
d. Protectstheheartfrom n n n
ninfection.
ANSWER:A n
Thesinoatrialnodeis thenaturalpacemaker of theheart, and it assists theheart tobeat in a Normal
n n n n n n n n n n n n n n n n n n n
rhythm. The sinoatrial node does not protect from atherosclerotic changes or infection,and it does not
n n n n n n n n n n n n n n n
directly provide the heart with oxygenated blood.
n n n n n n n
4. Thepatient is brought to the emergencydepartment aftera motor vehicle accident. Thepatient is
n n n n n n n n n n n n n n n n
diagnosed with internal bleeding. The nurses primary concern is to monitor for
n n n n n n n n n n n n
a. Mentalalertness. n
b. Perfusion.
, c. Pain.
d. Reactionto n
medications.
n
ANSWER: B n
Perfusion is thecorrect answer, because with internal bleeding, thenurseshould monitor vital
n n n n n n n n n n n n n
Signstobesureperfusionis happening. Mental alertness,pain, and medication reactions areimportant
n n n n n n n n n n n n n
but not the primary concern.
n n n n n
5. A patients serum electrolytes arebeingmonitored. Thenursenotices that thepotassium level is low.
n n n n n n n n n n n n n n n n
The nurse knows that the patient should be observed for
n n n n n n n n n n
a. Tissueischemia. n
b. Brainmalformations. n
c. Intestinalblockage. n
d. Cardiac
dysthymia.
n
ANSWER:D n
Cardiac dysthymia is a possibility when serum potassium is high or low. Tissue ischemia, brain Malformations,or
n n n n n n n n n n n n n n n n
intestinalblockagedonothaveadirect correlationtopotassium irregularities.
n n n n n n n n n n n
6. A nurseis explaining toastudentnurseaboutperfusion. Thenurseknows thestudent understands the
n n n n n n n n n n n n n n n n n
concept of perfusion when the student states, Perfusion
n n n n n n n n
a. Is anormal function of thebody, and Idont have to be concerned about it. n n n n n n n n n n n n n n n
b. Is monitored by thephysician, and Ijust follow orders.
n n n n n n n n n
c. Is monitored byvital signs and capillaryrefill.
n n n n n n n
d. Varies as apersonages, so Iwouldexpectchanges in the body. n n n n n n n n n n n n
ANSWER:C n
The best method to monitor perfusion is to monitor vital signs and capillary refill. This allows The
n n n n n n n n n n n n n n n n
nurse to know if perfusion is adequate to maintain vital organs. The nurse does have to be concerned
n n n n n n n n n n n n n n n n n n
about perfusion. Perfusion is not onlymonitored bythe physician but the nursetoo. Perfusion does not
n n n n n n n n n n n n n n n n n
always change as the person ages.
n n n n n n
7. The nurse is conducting a patient assessment. The patient tells the nurse that he has smoked two
n n n n n n n n n n n n n n n n n
packs of cigarettes per dayfor 27 years. The nursemayfind which data upon assessment?
n n n n n n n n n n n n n n n n
a. Blood pressure abovethe normal range n n n n n
b. Boundingpedal pulses n n
c. Nightblindness n