Med/Surg Exam #1 WITH CORRECT n n n n
ANSWERS
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A ,patient ,is ,seen ,at ,the ,clinic ,for ,a ,routine ,physical ,examination. ,After ,the ,patient ,is ,assessed ,for
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,evidence ,of ,peripheral ,vascular ,disease, ,the ,nurse ,explains ,that ,which ,of ,the ,following ,tests ,is ,typically
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,used ,to ,assist ,in ,the ,diagnosis?
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1. ,Allen's ,Test
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2. ,Ankle ,brachial ,pressure ,index.
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3. ,Cardiac ,Stress ,Test. ,
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4. ,Echocardiogram ,- ,correct ,answers-2. ,Ankle ,brachial ,pressure ,index.
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Rationale: ,The ,ankle ,brachial ,index ,(ABI) ,is ,the ,blood ,pressure ,ratio ,between ,the ,lower ,legs ,and ,the
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,arms. ,Blood ,pressure ,in ,the ,legs ,is ,normally ,higher ,than ,the ,arms, ,and ,abnormalities ,indicate
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,narrowing ,of ,the ,arteries. ,Clinical ,findings ,that ,may ,suggest ,the ,presence ,of ,PVD ,includes ,a ,history ,of
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,angina ,with ,activity, ,intermittent ,claudication, ,and ,abnormal ,(weak ,or ,absent) ,pedal ,pulses. ,The
n n n n n n n n n n n n n
,formula ,for ,ABI ,is ,the ,systolic ,blood ,pressure ,of ,the ,ankle ,(measured ,at ,the ,dorsalis ,pedis ,or ,posterior
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,tibial ,arteries) ,divided ,by ,the ,systolic ,pressure ,in ,the ,arms. ,It ,is ,measured ,on ,both ,sides. ,A ,ratio ,of ,1.0
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,indicates ,peripheral ,vascular ,disease. ,Incorrect: ,Allen's ,test ,is ,used ,to ,assess ,blood ,supply ,to ,the
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,hand.Incorrect: ,Cardiac ,stress ,tests ,are ,used ,to ,measure ,the ,heart's ,ability ,to ,respond ,to ,stress.
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,Incorrect: ,ECG ,evaluates ,the ,structure ,and ,function ,of ,the ,heart ,muscle, ,but ,does ,not ,tell ,if ,there ,is
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,peripheral ,vascular ,disease ,present.
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A ,patient ,has ,been ,diagnosed ,with ,left-sided ,congestive ,heart ,failure, ,and ,is ,confused ,about ,the ,return
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,of ,oxygenated ,blood ,from ,the ,lungs. ,To ,clarify ,the ,confusion, ,the ,nurse ,explains ,all ,chambers ,of ,the
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,heart ,dealing ,with ,blood ,circulation. ,The ,nurse ,is ,correct ,when ,she ,tells ,the ,client:
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1. ,A ,muscular ,space ,called ,the ,pericardial ,space ,separates ,the ,chambers ,of ,the ,right ,side ,from ,the ,left
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,side. ,
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2. ,Blood ,flows ,into ,the ,left ,ventricle ,which ,pumps ,it ,out ,against ,high ,resistance ,into ,the ,systemic
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,circulation. ,
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3. ,The ,blood ,moves ,to ,the ,left ,ventricle, ,which ,pumps ,blood ,into ,the ,lungs. ,
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,3. ,The ,heart ,consists ,of ,5 ,chambers. ,
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4. ,The ,left ,atrium ,receives ,oxygenated ,blood ,from ,the ,lungs. ,
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5. ,The ,right ,atrium ,receives ,deoxygenated ,blood ,from ,the ,body ,tissues. ,- ,correct ,answers-2. ,Blood
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,flows ,into ,the ,left ,ventricle ,which ,pumps ,it ,out ,against ,high ,resistance ,into ,the ,systemic ,circulation. ,
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3. ,The ,blood ,moves ,to ,the ,left ,ventricle, ,which ,pumps ,blood ,into ,the ,lungs. ,
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4. ,The ,left ,atrium ,receives ,oxygenated ,blood ,from ,the ,lungs. ,
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5. ,The ,right ,atrium ,receives ,deoxygenated ,blood ,from ,the ,body ,tissues. ,
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Rationale: ,Heart ,consists ,of ,4 ,chambers: ,2 ,atria ,and ,2 ,ventricles. ,The ,right ,and ,left ,chambers ,are
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,separated ,down ,the ,middle ,of ,the ,heart ,by ,a ,septum, ,like ,a ,wall. ,The ,right ,atrium ,receives
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,deoxygenated ,from ,the ,body, ,and ,the ,blood ,then ,moves ,down ,into ,the ,right ,ventricle, ,which ,pumps ,it
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,to ,the ,lungs ,with ,low ,resistance. ,The ,left ,atrium ,then ,receives ,oxygenated ,blood ,from ,the ,lungs, ,and
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,that ,blood ,moves ,down ,into ,the ,left ,ventricle. ,The ,left ,ventricle, ,which ,is ,the ,most ,muscular ,chamber,
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,pumps ,oxygen ,rich ,blood ,into ,the ,systemic ,circulation.
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A ,patient ,recovering ,from ,a ,MI ,has ,been ,in ,bed ,for ,6 ,days. ,The ,patient ,now ,complains ,of ,calf ,pain. ,The
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,nurse ,should ,first: ,
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1. ,Administer ,pain ,medication ,as ,ordered. ,
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2. ,Assess ,the ,calf ,for ,redness ,warmth ,and ,swelling. ,
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3. ,Massage ,the ,calf ,to ,relieve ,the ,muscle ,cramp. ,
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Observe ,the ,patient ,walking. ,- ,correct ,answers-2. ,Assess ,the ,calf ,for ,redness ,warmth ,and ,swelling. ,
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Rationale: ,Due ,to ,the ,time ,spend ,in ,bed ,and ,inactive, ,the ,patient ,is ,at ,high ,risk ,for ,the ,development ,of
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,a ,DVT. ,Pain ,in ,the ,calf, ,redness ,or ,heat, ,and ,swelling ,in ,the ,affected ,extremity ,are ,signs ,of ,a ,DVT.
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,Diagnostic ,tests ,that ,help ,diagnose ,a ,DVT ,include ,a ,D-dimer ,test ,to ,confirm ,the ,presence ,of ,fibrin
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,degradation ,in ,products ,from ,a ,clot, ,venous ,ultrasound, ,venography ,to ,visualize ,the ,clot ,with ,contrast,
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,or ,less ,commonly ,MRI ,or ,CT.
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The ,nurse ,is ,caring ,for ,a ,patient ,in ,the ,early ,stages ,of ,heart ,failure. ,The ,family ,is ,curious ,as ,to ,how ,the
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,body ,adapts ,to ,heart ,failure. ,The ,nurse ,knows ,that ,during ,the ,early ,stages ,of ,heart ,failure, ,which
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,specific ,compensatory ,mechanisms ,occur? ,
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1. ,Decreased ,cardiac ,output ,inhibits ,the ,release ,of ,ADH ,by ,the ,pituitary ,gland.
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2. ,Hypotension ,stimulates ,the ,baroreceptors ,to ,increase ,sympathetic ,activity. ,
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,3. ,Hypotension ,stimulates ,the ,baroreceptors ,to ,decrease ,sympathetic ,activity. ,
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4. ,Impaired ,renal ,perfusion ,inhibits ,aldosterone ,release. ,- ,correct ,answers-2. ,Hypotension ,stimulates
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,the ,baroreceptors ,to ,increase ,sympathetic ,activity. ,
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Rationale: ,As ,arterial ,blood ,pressure ,falls, ,the ,baroreceptors ,of ,the ,carotid ,and ,aorta ,are ,stimulated.
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,This ,causes ,a ,sympathetic ,release ,of ,catecholamines, ,resulting ,in ,vasoconstriction ,and ,an ,increased
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,heart ,rate ,to ,compensate. ,The ,compensatory ,mechanism ,increases ,peripheral ,vascular ,resistance ,and
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,also ,the ,work ,load ,of ,the ,heart. ,This ,can ,worsen ,heart ,failure ,if ,not ,treated. ,
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Incorrect: ,Decreased ,cardiac ,output ,will ,INCREASE ,ADH ,release, ,leading ,to ,fluid ,retention. ,
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Incorrect: ,Impaired ,renal ,perfusion ,will ,stimulate ,aldosterone ,release ,leading ,to ,addition ,fluid ,and
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,sodium ,retention.
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The ,nurse ,is ,assessing ,a ,patient ,with ,atrial ,fibrillation ,and ,a ,rapid ,ventricular ,rate. ,The ,nurse ,would
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,expect ,to ,see:
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1. ,Distended ,juglar ,veins. ,
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2. ,Dizziness ,and ,hypotension. ,
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3. ,Hypertension ,and ,headache. ,
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4. ,Lower ,extremity ,pain. ,- ,correct ,answers-2. ,Dizziness ,and ,hypotension. ,
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Rationale: ,Atrial ,fibrillation ,is ,any ,arrhythmia ,in ,which ,the ,atria ,initiate ,rapid, ,ineffective ,contractions
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,that ,are ,not ,synchronized ,with ,ventricular ,contractions. ,This ,patient ,has ,uncontrolled ,atrial ,fibrillation,
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,which ,can ,result ,in ,a ,low ,cardiac ,output. ,Signs ,and ,symptoms ,of ,a ,low ,cardiac ,output ,include
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,hypotension, ,dizziness, ,weakness, ,fatigue, ,shortness ,of ,breath, ,and ,syncope.
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The ,nurse ,is ,caring ,for ,a ,patient ,scheduled ,to ,undergo ,a ,mitral ,valve ,replacement. ,The ,nurse ,should
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,monitor ,for ,which ,complication ,of ,mitral ,stenosis?
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1. ,Left-sided ,heart ,failure. ,
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2. ,MI
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3. ,Pulmonary ,Hypertension ,
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4. ,Respiratory ,Alkalosis ,- ,correct ,answers-3. ,Pulmonary ,Hypertension ,
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, Rationale: ,Mitral ,stenosis ,impeded ,blood ,flow ,from ,the ,left ,atrium ,to ,the ,left ,ventricle ,of ,the ,heart.
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,This ,creates ,increased ,pulmonary ,vascular ,resistance, ,causing ,pulmonary ,hypertension. ,Other
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,complications ,of ,mitral ,stenosis ,include ,edema, ,right-sided ,heart ,failure, ,and ,reduced ,cardiac ,output.
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A ,nurse ,is ,assessing ,a ,patient ,who ,has ,longstanding ,hypertension. ,The ,nurse ,know ,that ,complications
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,of ,hypertension ,are ,possibly ,arising ,when ,which ,of ,the ,following ,signs ,are ,noted?
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1. ,Dyspnea ,during ,activity
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2. ,Fatigability ,
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3. ,Recurrent ,episodes ,of ,severe ,headache. ,
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4. ,Trace ,proteins ,in ,the ,urinalysis. ,- ,correct ,answers-4. ,Trace ,proteins ,in ,the ,urinalysis. ,
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Proteinuria ,and ,albuminuria ,are ,early ,indications ,of ,renal ,injury, ,a ,serious ,complication ,that ,can ,be
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,caused ,by ,hypertension. ,High ,pressures ,damage ,the ,kidney's ,ability ,to ,filter ,toxins, ,and ,evidence ,of
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,this ,damage ,is ,seen ,as ,proteins ,leak ,out ,of ,the ,urine. ,The ,other ,choices ,are ,not ,direct ,indicators ,of
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,progressive ,disease ,or ,complications. ,Fatigability ,and ,headache ,are ,symptoms ,of ,hypertension ,but ,are
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,not ,direct ,indicators ,of ,progressive ,disease ,or ,complications. ,These ,may ,be ,side ,effects ,of ,certain
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,medications ,used ,to ,treat ,hypertension. ,Dyspnea ,during ,activity ,is ,NOT ,associated ,with ,hypertension.
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,Dyspnea ,can ,be ,a ,sign ,of ,low ,cardiac ,output ,(congestive ,heart ,failure), ,pulmonary ,edema, ,severe
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,anemia, ,or ,a ,respiratory ,problem ,(asthma, ,pneumonia, ,etc.). ,;./
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The ,nurse ,is ,evaluating ,a ,52 ,year ,old ,male ,for ,risk ,factors ,for ,CAD. ,The ,patient ,is ,overweight, ,male, ,and
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,smokes ,a ,pack ,a ,day. ,The ,nurse ,questions ,the ,patient ,about ,other ,risk ,factors ,including:
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1) ,A ,history ,of ,atherosclerotic ,heart ,disease. ,
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2) ,A ,history ,of ,diabetes. ,
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3) ,A ,history ,of ,gout. ,
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4) ,Elevated ,HDL ,levels. ,- ,correct ,answers-2) ,A ,history ,of ,diabetes.
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Rationale: ,The ,major ,risk ,factors ,for ,CAD ,are ,diabetes, ,smoking, ,increased ,LDL ,levels, ,and ,hypertension.
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,Elevated ,HDL ,levels ,are ,PROTECTIVE ,against ,CAD. ,Atherosclerotic ,heart ,disease ,is ,just ,another ,name
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,for ,coronary ,heart ,disease. ,Gout ,is ,not ,associated ,with ,CAD.
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The ,nurse ,is ,knowledgeable ,about ,sinoatrial ,node ,dysrhythmias ,if ,she ,selects ,which ,of ,the ,following
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,causes ,of ,sinus ,tachycardia? ,Select ,all ,that ,apply.
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1. ,Emotional ,and ,physical ,stress
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ANSWERS
n
A ,patient ,is ,seen ,at ,the ,clinic ,for ,a ,routine ,physical ,examination. ,After ,the ,patient ,is ,assessed ,for
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,evidence ,of ,peripheral ,vascular ,disease, ,the ,nurse ,explains ,that ,which ,of ,the ,following ,tests ,is ,typically
n n n n n n n n n n n n n n n n
,used ,to ,assist ,in ,the ,diagnosis?
n n n n n n
1. ,Allen's ,Test
n n
2. ,Ankle ,brachial ,pressure ,index.
n n n n
3. ,Cardiac ,Stress ,Test. ,
n n n n
4. ,Echocardiogram ,- ,correct ,answers-2. ,Ankle ,brachial ,pressure ,index.
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Rationale: ,The ,ankle ,brachial ,index ,(ABI) ,is ,the ,blood ,pressure ,ratio ,between ,the ,lower ,legs ,and ,the
n n n n n n n n n n n n n n n n
,arms. ,Blood ,pressure ,in ,the ,legs ,is ,normally ,higher ,than ,the ,arms, ,and ,abnormalities ,indicate
n n n n n n n n n n n n n n n
,narrowing ,of ,the ,arteries. ,Clinical ,findings ,that ,may ,suggest ,the ,presence ,of ,PVD ,includes ,a ,history ,of
n n n n n n n n n n n n n n n n n
,angina ,with ,activity, ,intermittent ,claudication, ,and ,abnormal ,(weak ,or ,absent) ,pedal ,pulses. ,The
n n n n n n n n n n n n n
,formula ,for ,ABI ,is ,the ,systolic ,blood ,pressure ,of ,the ,ankle ,(measured ,at ,the ,dorsalis ,pedis ,or ,posterior
n n n n n n n n n n n n n n n n n n
,tibial ,arteries) ,divided ,by ,the ,systolic ,pressure ,in ,the ,arms. ,It ,is ,measured ,on ,both ,sides. ,A ,ratio ,of ,1.0
n n n n n n n n n n n n n n n n n n n n
,indicates ,peripheral ,vascular ,disease. ,Incorrect: ,Allen's ,test ,is ,used ,to ,assess ,blood ,supply ,to ,the
n n n n n n n n n n n n n n n
,hand.Incorrect: ,Cardiac ,stress ,tests ,are ,used ,to ,measure ,the ,heart's ,ability ,to ,respond ,to ,stress.
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,Incorrect: ,ECG ,evaluates ,the ,structure ,and ,function ,of ,the ,heart ,muscle, ,but ,does ,not ,tell ,if ,there ,is
n n n n n n n n n n n n n n n n n n
,peripheral ,vascular ,disease ,present.
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A ,patient ,has ,been ,diagnosed ,with ,left-sided ,congestive ,heart ,failure, ,and ,is ,confused ,about ,the ,return
n n n n n n n n n n n n n n n
,of ,oxygenated ,blood ,from ,the ,lungs. ,To ,clarify ,the ,confusion, ,the ,nurse ,explains ,all ,chambers ,of ,the
n n n n n n n n n n n n n n n n n
,heart ,dealing ,with ,blood ,circulation. ,The ,nurse ,is ,correct ,when ,she ,tells ,the ,client:
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1. ,A ,muscular ,space ,called ,the ,pericardial ,space ,separates ,the ,chambers ,of ,the ,right ,side ,from ,the ,left
n n n n n n n n n n n n n n n n n
,side. ,
n n
2. ,Blood ,flows ,into ,the ,left ,ventricle ,which ,pumps ,it ,out ,against ,high ,resistance ,into ,the ,systemic
n n n n n n n n n n n n n n n n
,circulation. ,
n n
3. ,The ,blood ,moves ,to ,the ,left ,ventricle, ,which ,pumps ,blood ,into ,the ,lungs. ,
n n n n n n n n n n n n n n
,3. ,The ,heart ,consists ,of ,5 ,chambers. ,
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4. ,The ,left ,atrium ,receives ,oxygenated ,blood ,from ,the ,lungs. ,
n n n n n n n n n n
5. ,The ,right ,atrium ,receives ,deoxygenated ,blood ,from ,the ,body ,tissues. ,- ,correct ,answers-2. ,Blood
n n n n n n n n n n n n n n
,flows ,into ,the ,left ,ventricle ,which ,pumps ,it ,out ,against ,high ,resistance ,into ,the ,systemic ,circulation. ,
n n n n n n n n n n n n n n n n n
3. ,The ,blood ,moves ,to ,the ,left ,ventricle, ,which ,pumps ,blood ,into ,the ,lungs. ,
n n n n n n n n n n n n n n
4. ,The ,left ,atrium ,receives ,oxygenated ,blood ,from ,the ,lungs. ,
n n n n n n n n n n
5. ,The ,right ,atrium ,receives ,deoxygenated ,blood ,from ,the ,body ,tissues. ,
n n n n n n n n n n n
Rationale: ,Heart ,consists ,of ,4 ,chambers: ,2 ,atria ,and ,2 ,ventricles. ,The ,right ,and ,left ,chambers ,are
n n n n n n n n n n n n n n n n
,separated ,down ,the ,middle ,of ,the ,heart ,by ,a ,septum, ,like ,a ,wall. ,The ,right ,atrium ,receives
n n n n n n n n n n n n n n n n n
,deoxygenated ,from ,the ,body, ,and ,the ,blood ,then ,moves ,down ,into ,the ,right ,ventricle, ,which ,pumps ,it
n n n n n n n n n n n n n n n n n
,to ,the ,lungs ,with ,low ,resistance. ,The ,left ,atrium ,then ,receives ,oxygenated ,blood ,from ,the ,lungs, ,and
n n n n n n n n n n n n n n n n n
,that ,blood ,moves ,down ,into ,the ,left ,ventricle. ,The ,left ,ventricle, ,which ,is ,the ,most ,muscular ,chamber,
n n n n n n n n n n n n n n n n n
,pumps ,oxygen ,rich ,blood ,into ,the ,systemic ,circulation.
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A ,patient ,recovering ,from ,a ,MI ,has ,been ,in ,bed ,for ,6 ,days. ,The ,patient ,now ,complains ,of ,calf ,pain. ,The
n n n n n n n n n n n n n n n n n n n n
,nurse ,should ,first: ,
n n n n
1. ,Administer ,pain ,medication ,as ,ordered. ,
n n n n n n
2. ,Assess ,the ,calf ,for ,redness ,warmth ,and ,swelling. ,
n n n n n n n n n
3. ,Massage ,the ,calf ,to ,relieve ,the ,muscle ,cramp. ,
n n n n n n n n n
Observe ,the ,patient ,walking. ,- ,correct ,answers-2. ,Assess ,the ,calf ,for ,redness ,warmth ,and ,swelling. ,
n n n n n n n n n n n n n n n
Rationale: ,Due ,to ,the ,time ,spend ,in ,bed ,and ,inactive, ,the ,patient ,is ,at ,high ,risk ,for ,the ,development ,of
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,a ,DVT. ,Pain ,in ,the ,calf, ,redness ,or ,heat, ,and ,swelling ,in ,the ,affected ,extremity ,are ,signs ,of ,a ,DVT.
n n n n n n n n n n n n n n n n n n n n
,Diagnostic ,tests ,that ,help ,diagnose ,a ,DVT ,include ,a ,D-dimer ,test ,to ,confirm ,the ,presence ,of ,fibrin
n n n n n n n n n n n n n n n n n
,degradation ,in ,products ,from ,a ,clot, ,venous ,ultrasound, ,venography ,to ,visualize ,the ,clot ,with ,contrast,
n n n n n n n n n n n n n n n
,or ,less ,commonly ,MRI ,or ,CT.
n n n n n n
The ,nurse ,is ,caring ,for ,a ,patient ,in ,the ,early ,stages ,of ,heart ,failure. ,The ,family ,is ,curious ,as ,to ,how ,the
n n n n n n n n n n n n n n n n n n n n n
,body ,adapts ,to ,heart ,failure. ,The ,nurse ,knows ,that ,during ,the ,early ,stages ,of ,heart ,failure, ,which
n n n n n n n n n n n n n n n n n
,specific ,compensatory ,mechanisms ,occur? ,
n n n n n
1. ,Decreased ,cardiac ,output ,inhibits ,the ,release ,of ,ADH ,by ,the ,pituitary ,gland.
n n n n n n n n n n n n
2. ,Hypotension ,stimulates ,the ,baroreceptors ,to ,increase ,sympathetic ,activity. ,
n n n n n n n n n
,3. ,Hypotension ,stimulates ,the ,baroreceptors ,to ,decrease ,sympathetic ,activity. ,
n n n n n n n n n
4. ,Impaired ,renal ,perfusion ,inhibits ,aldosterone ,release. ,- ,correct ,answers-2. ,Hypotension ,stimulates
n n n n n n n n n n n
,the ,baroreceptors ,to ,increase ,sympathetic ,activity. ,
n n n n n n n
Rationale: ,As ,arterial ,blood ,pressure ,falls, ,the ,baroreceptors ,of ,the ,carotid ,and ,aorta ,are ,stimulated.
n n n n n n n n n n n n n n
,This ,causes ,a ,sympathetic ,release ,of ,catecholamines, ,resulting ,in ,vasoconstriction ,and ,an ,increased
n n n n n n n n n n n n n
,heart ,rate ,to ,compensate. ,The ,compensatory ,mechanism ,increases ,peripheral ,vascular ,resistance ,and
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,also ,the ,work ,load ,of ,the ,heart. ,This ,can ,worsen ,heart ,failure ,if ,not ,treated. ,
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Incorrect: ,Decreased ,cardiac ,output ,will ,INCREASE ,ADH ,release, ,leading ,to ,fluid ,retention. ,
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Incorrect: ,Impaired ,renal ,perfusion ,will ,stimulate ,aldosterone ,release ,leading ,to ,addition ,fluid ,and
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,sodium ,retention.
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The ,nurse ,is ,assessing ,a ,patient ,with ,atrial ,fibrillation ,and ,a ,rapid ,ventricular ,rate. ,The ,nurse ,would
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,expect ,to ,see:
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1. ,Distended ,juglar ,veins. ,
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2. ,Dizziness ,and ,hypotension. ,
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3. ,Hypertension ,and ,headache. ,
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4. ,Lower ,extremity ,pain. ,- ,correct ,answers-2. ,Dizziness ,and ,hypotension. ,
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Rationale: ,Atrial ,fibrillation ,is ,any ,arrhythmia ,in ,which ,the ,atria ,initiate ,rapid, ,ineffective ,contractions
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,that ,are ,not ,synchronized ,with ,ventricular ,contractions. ,This ,patient ,has ,uncontrolled ,atrial ,fibrillation,
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,which ,can ,result ,in ,a ,low ,cardiac ,output. ,Signs ,and ,symptoms ,of ,a ,low ,cardiac ,output ,include
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,hypotension, ,dizziness, ,weakness, ,fatigue, ,shortness ,of ,breath, ,and ,syncope.
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The ,nurse ,is ,caring ,for ,a ,patient ,scheduled ,to ,undergo ,a ,mitral ,valve ,replacement. ,The ,nurse ,should
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,monitor ,for ,which ,complication ,of ,mitral ,stenosis?
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1. ,Left-sided ,heart ,failure. ,
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2. ,MI
n
3. ,Pulmonary ,Hypertension ,
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4. ,Respiratory ,Alkalosis ,- ,correct ,answers-3. ,Pulmonary ,Hypertension ,
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, Rationale: ,Mitral ,stenosis ,impeded ,blood ,flow ,from ,the ,left ,atrium ,to ,the ,left ,ventricle ,of ,the ,heart.
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,This ,creates ,increased ,pulmonary ,vascular ,resistance, ,causing ,pulmonary ,hypertension. ,Other
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,complications ,of ,mitral ,stenosis ,include ,edema, ,right-sided ,heart ,failure, ,and ,reduced ,cardiac ,output.
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A ,nurse ,is ,assessing ,a ,patient ,who ,has ,longstanding ,hypertension. ,The ,nurse ,know ,that ,complications
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,of ,hypertension ,are ,possibly ,arising ,when ,which ,of ,the ,following ,signs ,are ,noted?
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1. ,Dyspnea ,during ,activity
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2. ,Fatigability ,
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3. ,Recurrent ,episodes ,of ,severe ,headache. ,
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4. ,Trace ,proteins ,in ,the ,urinalysis. ,- ,correct ,answers-4. ,Trace ,proteins ,in ,the ,urinalysis. ,
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Proteinuria ,and ,albuminuria ,are ,early ,indications ,of ,renal ,injury, ,a ,serious ,complication ,that ,can ,be
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,caused ,by ,hypertension. ,High ,pressures ,damage ,the ,kidney's ,ability ,to ,filter ,toxins, ,and ,evidence ,of
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,this ,damage ,is ,seen ,as ,proteins ,leak ,out ,of ,the ,urine. ,The ,other ,choices ,are ,not ,direct ,indicators ,of
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,progressive ,disease ,or ,complications. ,Fatigability ,and ,headache ,are ,symptoms ,of ,hypertension ,but ,are
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,not ,direct ,indicators ,of ,progressive ,disease ,or ,complications. ,These ,may ,be ,side ,effects ,of ,certain
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,medications ,used ,to ,treat ,hypertension. ,Dyspnea ,during ,activity ,is ,NOT ,associated ,with ,hypertension.
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,Dyspnea ,can ,be ,a ,sign ,of ,low ,cardiac ,output ,(congestive ,heart ,failure), ,pulmonary ,edema, ,severe
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,anemia, ,or ,a ,respiratory ,problem ,(asthma, ,pneumonia, ,etc.). ,;./
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The ,nurse ,is ,evaluating ,a ,52 ,year ,old ,male ,for ,risk ,factors ,for ,CAD. ,The ,patient ,is ,overweight, ,male, ,and
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,smokes ,a ,pack ,a ,day. ,The ,nurse ,questions ,the ,patient ,about ,other ,risk ,factors ,including:
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1) ,A ,history ,of ,atherosclerotic ,heart ,disease. ,
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2) ,A ,history ,of ,diabetes. ,
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3) ,A ,history ,of ,gout. ,
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4) ,Elevated ,HDL ,levels. ,- ,correct ,answers-2) ,A ,history ,of ,diabetes.
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Rationale: ,The ,major ,risk ,factors ,for ,CAD ,are ,diabetes, ,smoking, ,increased ,LDL ,levels, ,and ,hypertension.
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,Elevated ,HDL ,levels ,are ,PROTECTIVE ,against ,CAD. ,Atherosclerotic ,heart ,disease ,is ,just ,another ,name
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,for ,coronary ,heart ,disease. ,Gout ,is ,not ,associated ,with ,CAD.
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The ,nurse ,is ,knowledgeable ,about ,sinoatrial ,node ,dysrhythmias ,if ,she ,selects ,which ,of ,the ,following
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,causes ,of ,sinus ,tachycardia? ,Select ,all ,that ,apply.
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1. ,Emotional ,and ,physical ,stress
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