NR 304 Exam 1 Study Slides Questions With Complete
Solutions
A 22-year-old man comes to the clinic for an examination after
falling off his motorcycle and landing on his left side on the
handle bars. The nurse suspects that he may have injured his
spleen. Which of these statements is true regarding assessment
of the spleen in this situation?
A. The spleen can be enlarged as a result of trauma.
B. The spleen is normally felt on routine palpation.
C. If an enlarged spleen is noted, then the nurse should
thoroughly palpate to determine its size.
D. An enlarged spleen should not be palpated because it can
easily rupture. Correct Answers D
A is also true however, but D is the most correct.
(Text, pg 558)
A 35-year-old man is seen in the clinic for an infection in his left
foot. Which of these findings should the nurse expect to see
during an assessment of this patient?
A. Hard and fixed cervical nodes
B. Enlarged and tender inguinal nodes
C. Bilateral enlargement of the popliteal nodes
D. Pellet like nodes in the supraclavicular region Correct
Answers B: the inguinal nodes are located near the groin and
therefore would drain the left foot, which is the location of the
infection. This would cause them to be enlarged and tender.
-The cervical nodes are in the neck, and any hard and fixed
lymph nodes are a serious indication of a disease process such as
cancer
,- Bilateral enlargement is incorrect as the infection is noted to
only be present in the left foot.
-The supraclavicular region is to far superior to be associated
with a foot infection.
(Text, pg 513)
A 40-year-old man states that his physician told him that he has
a hernia. He asks the nurse to explain what a hernia is. Which
response by the nurse is appropriate?
A. "No need to worry. Most men your age develop hernias."
B. "A hernia is a loop of bowel protruding through a weak spot
in the abdominal muscles."
C. "A hernia is the result of prenatal growth abnormalities that
are just now causing problems."
D. "I'll have to have your physician explain this to you." Correct
Answers B
(Text, pg 546)
A 45-year-old man is in the clinic for a physical examination.
During the abdominal assessment, the nurse percusses the
abdomen and notices an area of dullness above the right costal
margin of approximately 11 cm. The nurse should:
A. Document the presence of hepatomegaly.
B. Ask additional health history questions regarding his alcohol
intake.
C. Describe this dullness as indicative of an enlarged liver, and
refer him to a physician.
D. Consider this finding as normal, and proceed with the
examination. Correct Answers D
(Text page 540)
,A 65-year-old patient is experiencing pain in his left calf when
he exercises that disappears after resting for a few minutes. The
nurse recognizes that this description is most consistent with
_______ the left leg.
A: Venous obstruction of your mom
B: Claudication due to venous abnormalities
C:Ischemia caused by a partial blockage of an artery supplying
blood.
D:Ischemia caused by the complete blockage of an artery
supplying Correct Answers C
(I'm not able to find rationale for this question. I don't know that
it's accurate. In my opinion, the RN should assess for
musculoskeletal related issues related to the pain before jumping
the gun and assuming the man has a partially blocked artery).
A 67-year-old patient states that he recently began to have pain
in his left calf when climbing the 10 stairs to his apartment. This
pain is relieved by sitting for approximately 2 minutes; then he
is able to resume his activities. The nurse interprets that this
patient is most likely experiencing:
Claudication.
Sore muscles.
Muscle cramps.
Venous insufficiency Correct Answers A
"With PAD, blood flow cannot match muscle demand during
exercise; therefore people feel muscle fatigue or pain when
walking (claudication). But only 10% of those with PAD have
this classic symptom; 40% do not have leg pain, and 50% have
varying leg symptoms." -Text pg 514, second box on the right.
Also see Table 20-3 on page 531.
, A 70-year-old patient is scheduled for open-heart surgery. The
surgeon plans to use the great saphenous vein for the coronary
bypass grafts. The patient asks, "What happens to my circulation
when this vein is removed?" The nurse should reply:
A: "Venous insufficiency is a common problem after this type of
surgery."
B: "Oh, you have lots of veins—you won't even notice that it
has been removed."
C: "You will probably experience decreased circulation after the
vein is removed."
D: "This vein can be removed without harming your circulation
because the deeper veins in your leg are in good condition."
Correct Answers D
(Text pg 509)
A nurse notices that a patient has ascites, which indicates the
presence of:
A. Fluid.
B. Feces.
C. Flatus.
D. Fibroid tumors Correct Answers A.
(Text pg 552)
A patient complains of leg pain that wakes him at night. He
states that he "has been having problems" with his legs. He has
pain in his legs when they are elevated that disappears when he
dangles them. He recently noticed "a sore" on the inner aspect of
the right ankle. On the basis of this health history information,
the nurse interprets that the patient is most likely experiencing:
Pain related to lymphatic abnormalities.
Problems related to arterial insufficiency.
Solutions
A 22-year-old man comes to the clinic for an examination after
falling off his motorcycle and landing on his left side on the
handle bars. The nurse suspects that he may have injured his
spleen. Which of these statements is true regarding assessment
of the spleen in this situation?
A. The spleen can be enlarged as a result of trauma.
B. The spleen is normally felt on routine palpation.
C. If an enlarged spleen is noted, then the nurse should
thoroughly palpate to determine its size.
D. An enlarged spleen should not be palpated because it can
easily rupture. Correct Answers D
A is also true however, but D is the most correct.
(Text, pg 558)
A 35-year-old man is seen in the clinic for an infection in his left
foot. Which of these findings should the nurse expect to see
during an assessment of this patient?
A. Hard and fixed cervical nodes
B. Enlarged and tender inguinal nodes
C. Bilateral enlargement of the popliteal nodes
D. Pellet like nodes in the supraclavicular region Correct
Answers B: the inguinal nodes are located near the groin and
therefore would drain the left foot, which is the location of the
infection. This would cause them to be enlarged and tender.
-The cervical nodes are in the neck, and any hard and fixed
lymph nodes are a serious indication of a disease process such as
cancer
,- Bilateral enlargement is incorrect as the infection is noted to
only be present in the left foot.
-The supraclavicular region is to far superior to be associated
with a foot infection.
(Text, pg 513)
A 40-year-old man states that his physician told him that he has
a hernia. He asks the nurse to explain what a hernia is. Which
response by the nurse is appropriate?
A. "No need to worry. Most men your age develop hernias."
B. "A hernia is a loop of bowel protruding through a weak spot
in the abdominal muscles."
C. "A hernia is the result of prenatal growth abnormalities that
are just now causing problems."
D. "I'll have to have your physician explain this to you." Correct
Answers B
(Text, pg 546)
A 45-year-old man is in the clinic for a physical examination.
During the abdominal assessment, the nurse percusses the
abdomen and notices an area of dullness above the right costal
margin of approximately 11 cm. The nurse should:
A. Document the presence of hepatomegaly.
B. Ask additional health history questions regarding his alcohol
intake.
C. Describe this dullness as indicative of an enlarged liver, and
refer him to a physician.
D. Consider this finding as normal, and proceed with the
examination. Correct Answers D
(Text page 540)
,A 65-year-old patient is experiencing pain in his left calf when
he exercises that disappears after resting for a few minutes. The
nurse recognizes that this description is most consistent with
_______ the left leg.
A: Venous obstruction of your mom
B: Claudication due to venous abnormalities
C:Ischemia caused by a partial blockage of an artery supplying
blood.
D:Ischemia caused by the complete blockage of an artery
supplying Correct Answers C
(I'm not able to find rationale for this question. I don't know that
it's accurate. In my opinion, the RN should assess for
musculoskeletal related issues related to the pain before jumping
the gun and assuming the man has a partially blocked artery).
A 67-year-old patient states that he recently began to have pain
in his left calf when climbing the 10 stairs to his apartment. This
pain is relieved by sitting for approximately 2 minutes; then he
is able to resume his activities. The nurse interprets that this
patient is most likely experiencing:
Claudication.
Sore muscles.
Muscle cramps.
Venous insufficiency Correct Answers A
"With PAD, blood flow cannot match muscle demand during
exercise; therefore people feel muscle fatigue or pain when
walking (claudication). But only 10% of those with PAD have
this classic symptom; 40% do not have leg pain, and 50% have
varying leg symptoms." -Text pg 514, second box on the right.
Also see Table 20-3 on page 531.
, A 70-year-old patient is scheduled for open-heart surgery. The
surgeon plans to use the great saphenous vein for the coronary
bypass grafts. The patient asks, "What happens to my circulation
when this vein is removed?" The nurse should reply:
A: "Venous insufficiency is a common problem after this type of
surgery."
B: "Oh, you have lots of veins—you won't even notice that it
has been removed."
C: "You will probably experience decreased circulation after the
vein is removed."
D: "This vein can be removed without harming your circulation
because the deeper veins in your leg are in good condition."
Correct Answers D
(Text pg 509)
A nurse notices that a patient has ascites, which indicates the
presence of:
A. Fluid.
B. Feces.
C. Flatus.
D. Fibroid tumors Correct Answers A.
(Text pg 552)
A patient complains of leg pain that wakes him at night. He
states that he "has been having problems" with his legs. He has
pain in his legs when they are elevated that disappears when he
dangles them. He recently noticed "a sore" on the inner aspect of
the right ankle. On the basis of this health history information,
the nurse interprets that the patient is most likely experiencing:
Pain related to lymphatic abnormalities.
Problems related to arterial insufficiency.
