nurs 190 quiz 5.0
62-year-old client presents to the ER with chest pain and diaphoresis and pallor that is
unrelieved by nitroglycerin which of the following is assessment - ANS Signs, level of
consciousness, and cardiac system
\A client presents with an enlargement of several cervical lymph nodes and asked the
nurse about the function of the structures what's the best response - ANS Your lymph
nodes help to remove infectious organisms
\During a cardiovascular assessment how should the nurse describe a thrill - ANS
Vibration that is palpable
\The nurse educator is teaching a group of nursing students to assess heart sounds
which response by a student indicates appropriate understanding of how S2 heart
sounds are produced - ANS It is a result from the closure of the semi lunar valve's
\The nurse is assessing a 20-year-old client and notes the presence of bilateral ear lobes
creases the nurse would choose which of the following actions - ANS Document findings
and alert physician
\The nurse is assessing a client who has a wrist restraint applied for which of the
following findings should the nurse loosen restraints - ANS The clients hand is cool in
pale
\The nurse is assessing a clients blood pressure the client asked the nurse why it is
important to feel for the brachial pulse prior to taking blood pressure what is the
response - ANS I am more likely to get an accurate reading if I do it this way
\The nurse is assessing a patient with rheumatic heart disease what is a common finding
an inspection on patients with this disease - ANS Flushed skin
\The nurse is caring for a client complaining of a painful hot area in the leg the area is red
and swollen which of the following action should the nurse perform next - ANS Notify the
position
\The nurse is caring for a client post cardiac catheterization is unable to locate pulses in
the right distal extremity with a Doppler which is the nurses priority action - ANS Access
for the client right popliteal pulse
\The nurse is caring for a client that is using cocaine which initial cardiovascular effects
takes place - ANS Coronary artery spasms
\The nurse is caring for a client who may have an arterial obstruction in her right on her
artery which of the following test maybe used to help determine the patency of this artery
- ANS Allen's test
\The nurse is documenting in ulcer on the lateral aspect of the clients right great toe the
nurse notes that the ulcer is pale with well defined edges and there is no evidence of
bleeding which other assessment that it would be useful to determine the origin of the
client ulcer - ANS Peripheral pulses
\The nurse is listening to the adult heart sounds expects to hear blank beats per minute
when normal sinus rhythm is present - ANS 60 to 90
62-year-old client presents to the ER with chest pain and diaphoresis and pallor that is
unrelieved by nitroglycerin which of the following is assessment - ANS Signs, level of
consciousness, and cardiac system
\A client presents with an enlargement of several cervical lymph nodes and asked the
nurse about the function of the structures what's the best response - ANS Your lymph
nodes help to remove infectious organisms
\During a cardiovascular assessment how should the nurse describe a thrill - ANS
Vibration that is palpable
\The nurse educator is teaching a group of nursing students to assess heart sounds
which response by a student indicates appropriate understanding of how S2 heart
sounds are produced - ANS It is a result from the closure of the semi lunar valve's
\The nurse is assessing a 20-year-old client and notes the presence of bilateral ear lobes
creases the nurse would choose which of the following actions - ANS Document findings
and alert physician
\The nurse is assessing a client who has a wrist restraint applied for which of the
following findings should the nurse loosen restraints - ANS The clients hand is cool in
pale
\The nurse is assessing a clients blood pressure the client asked the nurse why it is
important to feel for the brachial pulse prior to taking blood pressure what is the
response - ANS I am more likely to get an accurate reading if I do it this way
\The nurse is assessing a patient with rheumatic heart disease what is a common finding
an inspection on patients with this disease - ANS Flushed skin
\The nurse is caring for a client complaining of a painful hot area in the leg the area is red
and swollen which of the following action should the nurse perform next - ANS Notify the
position
\The nurse is caring for a client post cardiac catheterization is unable to locate pulses in
the right distal extremity with a Doppler which is the nurses priority action - ANS Access
for the client right popliteal pulse
\The nurse is caring for a client that is using cocaine which initial cardiovascular effects
takes place - ANS Coronary artery spasms
\The nurse is caring for a client who may have an arterial obstruction in her right on her
artery which of the following test maybe used to help determine the patency of this artery
- ANS Allen's test
\The nurse is documenting in ulcer on the lateral aspect of the clients right great toe the
nurse notes that the ulcer is pale with well defined edges and there is no evidence of
bleeding which other assessment that it would be useful to determine the origin of the
client ulcer - ANS Peripheral pulses
\The nurse is listening to the adult heart sounds expects to hear blank beats per minute
when normal sinus rhythm is present - ANS 60 to 90
