Nu 220 Midterm Exam Questions With 100 Correct Answers

NU 220 MIDTERM EXAM QUESTIONS WITH 100 CORRECT ANSWERS Inspection of nails (objective) - Answer--Shape and contour (clubbing, curved) -Consistency -Color -Capillary refill Primary lesions - Answer-The immediate result of a specific causative factor, primary lesions develop on previously unaltered skin Secondary lesions - Answer-Resulting from a change in a primary lesion from the passage of time, an evolutionary change. Combination lesions - Answer-Combination of primary and secondary lesions. Papulosquamous, maculopapular, vesiculopulstular, papulovesicular Papule vs macule - Answer-Macule: just a color change, flat and circumscribed (ex. freckles, hypopigmentation, petechiae, measles, scarlet fever) Papule: Something you can feel- solid, elevated, circumscribed, less than 1cm diameter (ex. elevated nevus/mole, lichen planus, molluscum/round firm painless bumps, wart/verruca) Annular lesions - Answer--Circular -Begins in center and spreads to periphery -Ex. Tinea corporis/ringworm, tinea versicolor, pityriasis rosea Confluent lesions - Answer--Lesions run together -Ex. uticaria (hives) Discrete lesions - Answer--Distinct, individual lesions -Lesions remain separate -Ex. acrochordon (skin tags), acne Lesion danger signs - Answer-ABCDE Asymmetry, Border, Color, Diameter (6mm), Elevation/Evolution Gyrate lesions - Answer-Twisted, coiled spiral, snakelike Grouped lesions - Answer-Clusters of lesions -Ex. vesicles, contact dermatitis Linear lesions - Answer-Scratch, streak, line, or stripe Target lesions - Answer-Aka "Iris" Resembles iris of eyes -Concentric rings of color in lesions -Ex. erythema multiforme Zosteriform lesions - Answer--Linear arrangement along a unilateral nerve route -Ex. herpes zoster Polycyclic lesions - Answer--Annular lesions grow together -Ex. lichen planus, psoriasis 3 normal breath sounds - Answer-1.Bronchial -High, loud -Heard over trachea and larynx -Harsh, hollow, tubular -More in expiration 2. Bronchiovesicular -Moderate pitch and amplitude -Heard over major bronchi where fewer alveoli are located, between scapulae posteriorly -Mixed quality -Inspiration=expiration 3. Vesicular -Low, soft -Heard more in inspiration -Rustling noise -Heard over peripheral lung fields where air flows through smaller bronchioles and alveoli Crackles - Answer-Discontinuous popping sounds heard over inspiration Wheezes - Answer-Continuous musical sounds heard mainly over expiration 10 traps of interviewing - Answer-1. Providing false assurance/reassurance 2. Giving unwanted advice 3. Using authority 4. Using avoidance language 5. Distancing 6. Using professional jargon 7. Using leading/biased questions 8. Talking too much 9. Interrupting 10. Using why questions Measurement of pulmonary function status - Answer--Forced expiratory time= # of seconds it takes for a person to exhale from total lung capacity to residual volume, screening measure of airflow obstruction -Spirometer measure lung health -Pulse oximeter (normal 97-99%) -6 minute walk test (6MWT) Forced vital capacity (FVC) - Answer--Total volume of air exhaled FEV1 - Answer-Forced expiratory volume in 1 second Normal FEV1/FVC ratio - Answer-75% or greater Normal respiratory pattern - Answer--10 to 20 breaths/min -500 to 800 mL -Even pattern -Ratio constant -Air moving in and out with each respiration -Occasional sighs normal Tachypnea - Answer--RR 24/min -Rapid shallow breathing -Normal response to fever, fear, exercise -Also happens w/ respiratory insufficiency, pneumonia, alkalosis, pleurisy, lesions in the pons Bradypnea - Answer--Slow breathing -Decreased but regular rate -RR 10/min -Ex. drug induced depression of respiratory center in medulla, ICP, diabetic coma Cheyne-stokes respiration - Answer--Respirations gradually wax and wane in a normal pattern (30-45 sec) followed by 20 seconds of apnea -Severe heart failure most common cause -Also: renal failure, meningitis, drug overdose, ICP -Infants and elderly in sleep Hyperventilation - Answer--Increase in rate and depth -Ex. exertion, fear/anxiety, diabetic ketoacidosis (Kussmaul), salicylate overdose, lesions of midbrain, alteration of blood gas concentration -decreased level of CO2 in blood (alkalosis) Hypoventilation - Answer--Irregular shallow pattern -Ex. anesthetic or narcotic overdose, prolonged bed rest, chest splinting Biot respiration - Answer--Pattern is irregular (differentiates from cheyne stokes) -Normal respirations (3-4) followed by apnea -Cycle length is 10 sec-1 min -Ex. head trauma, brain abscess, heat stroke, spinal meningitis, encephalitis Chronic obstructive breathing - Answer--Normal inspiration and prolonged expiration -Used to overcome increased airway resistance -Increased HR can lead to severe dyspnea Abnormal findings with tactile fremitus - Answer--Increased: increased density of lung tissue (ex. pneumonia), consolidation must extend to lung tissue -Decreased: From obstructed transmission of vibrations (ex. pleural effusion, pneumothorax, emphesema) -Ronchal: vibration felt when inhaled air passes through thick secretions, may decrease by coughing -Pleural friction: produced when inflammation of parietal or visceral pleura causes a decrease in normal lubricating fluid, makes a course grating sound, feels like leather grating together (aka palpable friction rub) Crackles/rales (fine crackles) - Answer--Discontinuous -High pitched -Short crackling popping sounds -Heard during inspiration -Sounds like rolling a strand of hair Crackles- course - Answer--Loud -Low pitched -Bubbling and gurgling sounds -Starts early in inspiration, can be present in expiration