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r/d Edition by Mariann M. Harding;
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Chapter 1 - 15
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,Clinical Reasoning Cases in Nursing 8th Edition Harding Snyder Test Bank
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Contents:
Chapter 1. Perfusion
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Chapter 2. Gas Exchange
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Chapter 3. Mobility
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Chapter 4. Digestion
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Chapter 5. Urinary Elimination
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Chapter 6. Intracranial Regulation
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Chapter 7. Metabolism and Glucose Regulation
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Chapter 8. Immunity
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Chapter 9. Cellular Regulation
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Chapter 10. Tissue Integrity
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Chapter 11. Cognition
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Chapter 12. Infection and Inflammation
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Chapter 13. Developmental
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Chapter 14. Reproductive
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Chapter 15. Mood, Stress, and Addiction
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,Chapter 1. Perfusion r/d r/d
ClinicalReasoning Cases in Nursing 8th EditionHarding Snyder Test Bank
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MULTIPLE CHOICE r/d
1. The nurse is explaining to a student nurse about impaired central perfusion. The nurse knows the
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student understands this problem when the student states, Central perfusion
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a. Is monitored onlybythe physician. r/d r/d r/d r/d r/d
b. Involves the entire body. r/d r/d r/d
c. Is decreasedwith hypertension.
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d. Is toxicto thecardiac system.
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ANSWER: B r/d
Centralperfusiondoes involvetheentirebody as all organs aresuppliedwith oxygen andvital Nutrients.
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The physician does not control the bodys ability for perfusion. Central perfusion is notdecreased with
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hypertension. Central perfusion is not toxic to the cardiac system.
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2. A patientwas diagnosed with hypertension. Thepatient asks thenursehow this disease could have
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happened to them. The nurses best response is Hypertension
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a. Happens to everyone sooner or later. Dont be concerned about it. r/d r/d r/d r/d r/d r/d r/d r/d r /d r/d
b. Can happen from eating apoor diet, so change what you areeating.
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c. Canhappen from arterial changes thatimpede the blood flow.
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d. Happenswhenpeopledo notexercise,so youshouldwalk every day. r/d r/d r/d r/d r/d r/d r/d r/d r/d r/d r/d
ANSWER: C r/d
Hardening of the arteries from atherosclerosis can cause hypertension in the patient. Hypertension
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does not happen to everyone. Changing the patients diet and exercising maybe a positive life change,
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but these answers do not explain to the patient how the disease could have happened.
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3. The patient asks the nurse to explain the sinoatrial node in the heart. The nurses best response would
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be, The sinoatrial node
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a. Provides the heart with the stimulation to beat in anormal rhythm. r/d r/d r/d r/d r/d r/d r/d r/d r /d r/d r/d
b. Protects theheartfromatherosclerotic changes. r/d r/d r/d r/d r /d
c. Provides theheart with oxygenated blood. r/d r/d r/d r/d r/d
d. Protectstheheartfrom r/d r/d r/d
r/d infection.
ANSWER: A r/d
Thesinoatrialnodeis the natural pacemaker of theheart, and it assists the heart to beat in a Normal
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rhythm. The sinoatrial node does not protect from atherosclerotic changes or infection,and it does not
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directly provide the heart with oxygenated blood.
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4. The patient is brought to the emergencydepartment after a motor vehicle accident. The patient is
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diagnosed with internal bleeding. The nurses primary concern is to monitor for
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a. Mentalalertness. r/d
b. Perfusion.
, c. Pain.
d. Reactionto r/d
medications.
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ANSWER: B r/d
Perfusion is thecorrect answer, because with internalbleeding, the nurse should monitor vital r/d r/d r/d r/d r/d r/d r/d r/d r/d r/d r/d r /d r/d
Signs to be sureperfusion is happening. Mental alertness, pain, and medication reactions areimportant
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but not the primary concern.
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5. A patients serum electrolytes are being monitored. The nursenotices that the potassium level is low.
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The nurse knows that the patient should be observed for
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a. Tissueischemia. r/d
b. Brainmalformations. r/d
c. Intestinalblockage. r/d
d. Cardiac
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ANSWER: D r/d
Cardiac dysthymia is a possibility when serum potassium is high or low. Tissue ischemia, brain Malformations,
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orintestinal blockagedonothaveadirect correlation topotassium irregularities.
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6. A nurseis explaining to astudent nurseabout perfusion. Thenurse knows the student understands the
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concept of perfusion when the student states, Perfusion
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a. Is a normal function of the body, and I dont have to be concerned about it. r/d r/d r/d r/d r /d r/d r/d r/d r/d r/d r/d r/d r/d r/d r/d
b. Is monitored by the physician, and I just follow orders.
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c. Is monitored byvital signs and capillaryrefill.
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d. Varies as apersonages, so Iwould expectchanges in the r/d r/d r/d r/d r/d r/d r/d r/d r/d r/d r/d
r/d body.
ANSWER: C r/d
The best method to monitor perfusion is to monitor vital signs and capillary refill. This allows The
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nurse to know if perfusion is adequate to maintain vital organs. The nurse does have to be concerned
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about perfusion. Perfusion is not only monitored by the physician but the nurse too. Perfusion does
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not always change as the person ages.
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7. The nurse is conducting a patient assessment. The patient tells the nurse that he has smoked two
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packs of cigarettes per dayfor 27 years. The nurse mayfind which data upon assessment?
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a. Blood pressure above the normal range r/d r/d r/d r/d r/d
b. Boundingpedal pulses r/d r/d
c. Nightblindness r/d