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NR304 FINAL EXAM 2024 ACTUAL EXAM COMPLETE EXAM QUESTIONS AND CORRECT ANSWERS

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NR304 FINAL EXAM 2024 ACTUAL EXAM COMPLETE EXAM QUESTIONS AND CORRECT ANSWERS arteries - ANSWERS active blood flow veins - ANSWERS passive blood flow - do not have a pulse, returns to the heart via movement through the skeletal muscles femoral pulse site - ANSWERS groin popliteal pulse site - ANSWERS back of knee radial pulse site - ANSWERS Located at the wrist on the thumb side dorsalis pedis pulse site - ANSWERS top of foot posterior tibial pulse site - ANSWERS on medial surface of ankle near ankle bone ischemia - ANSWERS Lack of blood supply, causes pain necrosis - ANSWERS long term lack of blood supply, tissue death axillary lymph nodes - ANSWERS located under the arms in the armpits cervical lymph nodes - ANSWERS located along the sides of the neck Epitrochlear lymph nodes - ANSWERS Epitrochlear lymph nodes- drains from the hand and forearm inguinal lymph nodes - ANSWERS located in the inguinal (groin) area of the lower abdomen Children and Lymph Nodes - ANSWERS nodes can be enlarged with no pain/infection Pregnancy and PV - ANSWERS dependent edema, varicose veins peripheral artery disease - ANSWERS A form of peripheral vascular disease in which there is partial or total blockage of an artery, usually one leading to a leg or arm. 50% of cases are African Americans. RF: smoking, HTN, diabetes intermittent claudication - ANSWERS when walking, muscle needs more O2 blood, and you have any kind of occlusion, when walking pain is increased Pulse Scale - ANSWERS 0: absent 1+: weak 2+: normal 3+: increased, full, bounding Allen test - ANSWERS determining the patency of the radial and ulnar arteries by compressing one artery site and observing return of skin color as evidence of patency of the other artery, determine if radial artery has been damaged, press radial artery then see if ulnar artery perfuses to hand venous ulcers - ANSWERS bleed, medial malleolus arterial (ischemic) ulcers - ANSWERS does not bleed, has a necrotic black crust, lateral malleolus neuropathic ulcer - ANSWERS destroys nerve endings, burning pain/numbness Edema Scale - ANSWERS • 1+ Mild pitting, slight indentation, no perceptible swelling of the leg • 2+ Moderate pitting, indentation, subsides rapidly • 3+ Deep pitting, indentation remains for a short time, leg looks swollen • 4+ Very deep pitting, indentation lasts a long time, leg is very swollen Doppler ultrasound - ANSWERS determine location of pulse Raynaud's disease - ANSWERS autoimmune, sporadic vasoconstriction then relaxation, happens in hands/toes usually Lymphadema - ANSWERS enlarged lymph nodes, hard edema Varicose veins - ANSWERS abnormally swollen, twisted veins with defective valves; most often seen in the legs DVT - ANSWERS inflammatory process, swelling, redness, heat, pain, happens from venastasis, pooling of blood in calf -tachycardia, low grade temp -women on birth control who smoke are at a higher risk, and also those who are dehydrated since blood is more viscous -Do not perform homan's sign test (flexing foot back) anneurysm - ANSWERS can be born with or develop, serious with abdominal aorta/coronary arteries/brain Decreased Arterial Flow - ANSWERS doesn't work well around gravity, blue then pallor Decreased Venous Flow - ANSWERS brown, using muscles improves What happens when valves of the veins do not work right - ANSWERS edema/varicose veins arterial insufficiency - ANSWERS not getting enough arterial blood flow = ischemic pain, usually happens on one leg, leg appears shiny, hairless, red/blue then pallor, limb gets cool, pain gets better when resting since the limb doesn't need as much O2 blood flow (intermittent claudication), gravity works for it when legs are down, causes impotence in males, can affect nails/toes venous insufficiency - ANSWERS constant, achy, fullness, pain. Pain gets better by moving. When you stand/sit pain gets worse. Gravity works against when legs are down. Usually happens on both legs, skin turns red/brown, starts below the knee to the ankle, skin is scaly, can get slits in skin (weeping edema), there is no cure, no change in skin temp. pulse - ANSWERS rhythm, rate, symmetry, amplitude/strength arterial occlusion - ANSWERS -extreme coolness -pain -loss of sensation -hair loss and skin changes -pallor -pulselessness arterial insufficiency - ANSWERS -intermittent claudation (pain brought on by exercise and relieved with rest) -hair loss on toes and shiny skin -impotence -pain (gnawing, sharp or stabbing and increases with exercise, relieved with rest) -decreased pulses -rusty discoloration due to blood leaking out of vessel and difficulty being reabsorbed -skin ulcers on pressure points, toes, and lateral malleoli -necrosis -bluish/red feet with dependence and pallor with elevation -sensory and motor loss -thickened, yellow toenails -cool skin venous insufficiency - ANSWERS -pitting edema due to fluid leaking into tissue due to incompetent valves -pain (aching or feeling of fullness and increases with standing/sitting and improves with elevating legs or walking) -varicosities may be present -possible leg ulcers on medial malleoli -normal temperature -skin thickened with brown discoloration of ankles and flaky deep vein thrombosis - ANSWERS -edema (only on one leg) -pain - no pain or sharp, intense pain/tenderness -red skin area -warmth -mass -low grade fever -tachycardia Peripheral Neuropathy - ANSWERS -burning skin -numbness -loss/decreased sensation GERD - ANSWERS (pyrosis) - failure of pyloric valve, dont eat before bed or in middle of night, dont lie down after eating for at least 30 mins What causes peptic ulcers? - ANSWERS H. pylori - loves acid Small Bowel - ANSWERS -small in diameter, huge in length 20ft -where most digestion/breakdown ocurrs -where enzymes from pancreas go -most of absorption of nutrients ocurrs large bowel - ANSWERS -shorter but larger diameter -condense stool into formed stool (pulls water out) -where you metabolize fats to absorb vit. D E.coli - ANSWERS -essential bacteria that breaks down food in bowel -if it is any other placer than the gut, it can kill you -in wound = infection -bladder = UTI -lungs = dangerous pneumonia C. Diff - ANSWERS -if you take antibiotics you kill in gut, so you have an overgrowth of other microbes (importance of probiotics) -when you kill all this bacteria you get C.diff - terrible bacteria that can kill you -explosive diarrhea, highly contagious, gown/glove precautions, horrible smell -can prevent C. Diff by probiotics - can have yogurt with live cultures or need probiotic with 50 million bacteria Peristalsis - ANSWERS Involuntary waves of muscle contraction that keep food moving along in one direction through the digestive system. hyperactive peristalsis - ANSWERS diarrhea slowed peristalsis - ANSWERS constipation, any type of narcotic slows peristalsis a lot and can even cause a bowel obstruction/impaction -prevention: have pt. take a stool softener with pain pill -anesthesia, immobility, and dehydration can also slow peristalsis Ileostomy - ANSWERS removal of part of small bowel, can lead to malnutrition Colostomy - ANSWERS removal of part of large bowel, reversible hernia - ANSWERS protrusion of an organ or part through the tissues and muscles normally containing it chron's disease - ANSWERS autoimmune, destroying parts of lining of bowel, nutritionally depleted, anemia from bleeding

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NR304 FINAL EXAM 2024 ACTUAL
EXAM COMPLETE EXAM QUESTIONS
AND CORRECT ANSWERS
arteries - ANSWERS active blood flow

veins - ANSWERS passive blood flow - do not have a pulse, returns to the heart via
movement through the skeletal muscles

femoral pulse site - ANSWERS groin

popliteal pulse site - ANSWERS back of knee

radial pulse site - ANSWERS Located at the wrist on the thumb side

dorsalis pedis pulse site - ANSWERS top of foot

posterior tibial pulse site - ANSWERS on medial surface of ankle near ankle bone

ischemia - ANSWERS Lack of blood supply, causes pain

necrosis - ANSWERS long term lack of blood supply, tissue death

axillary lymph nodes - ANSWERS located under the arms in the armpits

cervical lymph nodes - ANSWERS located along the sides of the neck

Epitrochlear lymph nodes - ANSWERS Epitrochlear lymph nodes- drains from the
hand and forearm

inguinal lymph nodes - ANSWERS located in the inguinal (groin) area of the lower
abdomen

Children and Lymph Nodes - ANSWERS nodes can be enlarged with no
pain/infection

Pregnancy and PV - ANSWERS dependent edema, varicose veins

peripheral artery disease - ANSWERS A form of peripheral vascular disease in
which there is partial or total blockage of an artery, usually one leading to a leg or
arm. 50% of cases are African Americans. RF: smoking, HTN, diabetes

intermittent claudication - ANSWERS when walking, muscle needs more O2 blood,
and you have any kind of occlusion, when walking pain is increased

Pulse Scale - ANSWERS 0: absent
1+: weak
2+: normal

,3+: increased, full, bounding

Allen test - ANSWERS determining the patency of the radial and ulnar arteries by
compressing one artery site and observing return of skin color as evidence of
patency of the other artery, determine if radial artery has been damaged, press radial
artery then see if ulnar artery perfuses to hand

venous ulcers - ANSWERS bleed, medial malleolus

arterial (ischemic) ulcers - ANSWERS does not bleed, has a necrotic black crust,
lateral malleolus

neuropathic ulcer - ANSWERS destroys nerve endings, burning pain/numbness

Edema Scale - ANSWERS • 1+ Mild pitting, slight indentation, no perceptible
swelling of the leg
• 2+ Moderate pitting, indentation, subsides rapidly
• 3+ Deep pitting, indentation remains for a short time, leg looks swollen
• 4+ Very deep pitting, indentation lasts a long time, leg is very swollen

Doppler ultrasound - ANSWERS determine location of pulse

Raynaud's disease - ANSWERS autoimmune, sporadic vasoconstriction then
relaxation, happens in hands/toes usually

Lymphadema - ANSWERS enlarged lymph nodes, hard edema

Varicose veins - ANSWERS abnormally swollen, twisted veins with defective
valves; most often seen in the legs

DVT - ANSWERS inflammatory process, swelling, redness, heat, pain, happens
from venastasis, pooling of blood in calf
-tachycardia, low grade temp
-women on birth control who smoke are at a higher risk, and also those who are
dehydrated since blood is more viscous
-Do not perform homan's sign test (flexing foot back)

anneurysm - ANSWERS can be born with or develop, serious with abdominal
aorta/coronary arteries/brain

Decreased Arterial Flow - ANSWERS doesn't work well around gravity, blue then
pallor

Decreased Venous Flow - ANSWERS brown, using muscles improves

What happens when valves of the veins do not work right - ANSWERS
edema/varicose veins

arterial insufficiency - ANSWERS not getting enough arterial blood flow = ischemic
pain, usually happens on one leg, leg appears shiny, hairless, red/blue then pallor,

,limb gets cool, pain gets better when resting since the limb doesn't need as much O2
blood flow (intermittent claudication), gravity works for it when legs are down, causes
impotence in males, can affect nails/toes

venous insufficiency - ANSWERS constant, achy, fullness, pain. Pain gets better by
moving. When you stand/sit pain gets worse. Gravity works against when legs are
down. Usually happens on both legs, skin turns red/brown, starts below the knee to
the ankle, skin is scaly, can get slits in skin (weeping edema), there is no cure, no
change in skin temp.

pulse - ANSWERS rhythm, rate, symmetry, amplitude/strength

arterial occlusion - ANSWERS -extreme coolness
-pain
-loss of sensation
-hair loss and skin changes
-pallor
-pulselessness

arterial insufficiency - ANSWERS -intermittent claudation (pain brought on by
exercise and relieved with rest)
-hair loss on toes and shiny skin
-impotence
-pain (gnawing, sharp or stabbing and increases with exercise, relieved with rest)
-decreased pulses
-rusty discoloration due to blood leaking out of vessel and difficulty being reabsorbed
-skin ulcers on pressure points, toes, and lateral malleoli
-necrosis
-bluish/red feet with dependence and pallor with elevation
-sensory and motor loss
-thickened, yellow toenails
-cool skin

venous insufficiency - ANSWERS -pitting edema due to fluid leaking into tissue due
to incompetent valves
-pain (aching or feeling of fullness and increases with standing/sitting and improves
with elevating legs or walking)
-varicosities may be present
-possible leg ulcers on medial malleoli
-normal temperature
-skin thickened with brown discoloration of ankles and flaky

deep vein thrombosis - ANSWERS -edema (only on one leg)
-pain - no pain or sharp, intense pain/tenderness
-red skin area
-warmth
-mass
-low grade fever
-tachycardia

, Peripheral Neuropathy - ANSWERS -burning skin
-numbness
-loss/decreased sensation

GERD - ANSWERS (pyrosis) - failure of pyloric valve, dont eat before bed or in
middle of night, dont lie down after eating for at least 30 mins

What causes peptic ulcers? - ANSWERS H. pylori - loves acid

Small Bowel - ANSWERS -small in diameter, huge in length 20ft
-where most digestion/breakdown ocurrs
-where enzymes from pancreas go
-most of absorption of nutrients ocurrs

large bowel - ANSWERS -shorter but larger diameter
-condense stool into formed stool (pulls water out)
-where you metabolize fats to absorb vit. D

E.coli - ANSWERS -essential bacteria that breaks down food in bowel
-if it is any other placer than the gut, it can kill you
-in wound = infection
-bladder = UTI
-lungs = dangerous pneumonia

C. Diff - ANSWERS -if you take antibiotics you kill e.coli in gut, so you have an
overgrowth of other microbes (importance of probiotics)
-when you kill all this bacteria you get C.diff - terrible bacteria that can kill you
-explosive diarrhea, highly contagious, gown/glove precautions, horrible smell
-can prevent C. Diff by probiotics - can have yogurt with live cultures or need
probiotic with 50 million bacteria

Peristalsis - ANSWERS Involuntary waves of muscle contraction that keep food
moving along in one direction through the digestive system.

hyperactive peristalsis - ANSWERS diarrhea

slowed peristalsis - ANSWERS constipation, any type of narcotic slows peristalsis a
lot and can even cause a bowel obstruction/impaction
-prevention: have pt. take a stool softener with pain pill
-anesthesia, immobility, and dehydration can also slow peristalsis

Ileostomy - ANSWERS removal of part of small bowel, can lead to malnutrition

Colostomy - ANSWERS removal of part of large bowel, reversible

hernia - ANSWERS protrusion of an organ or part through the tissues and muscles
normally containing it

chron's disease - ANSWERS autoimmune, destroying parts of lining of bowel,
nutritionally depleted, anemia from bleeding

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