Clinical Reasoning Cases in Nursing
a a a a
7th Edition Harding Snyder Test Bank
a a a a a a
, Clinical aReasoning aCases ain aNursing a7th aEdition aHarding aSnyder aTest aBank
Chapter a1.Perfusion
MULTIPLE aCHOICE
1. The anurse ais aexplaining ato aa astudent anurse aabout aimpaired acentral aperfusion. aThe anurse
aknowsathe astudent a understands athis aproblem awhen athe astudent a states, aCentral aperfusion
a. is amonitored aonly aby athe aphysician.
b. involves athe aentire abody.
c. is adecreased awith ahypertension.
d. is atoxic ato athe acardiac asystem.
aANS: a B
Central aperfusion adoes ainvolve athe aentire abody aas aall aorgans aare asupplied awith aoxygen aand avital
nutrients. aThe aphysician adoes anot acontrol athe abodys aability afor aperfusion. aCentral aperfusion ais
anotadecreased awith a hypertension. a Central aperfusion ais anot atoxic ato athe acardiac asystem.
2. A apatient awas adiagnosed awith ahypertension. aThe apatient aasks athe anurse ahow athis adisease
acouldahave ahappened ato athem. a The anurses a best a response a is aHypertension
a. happens ato aeveryone asooner aor alater. aDont abe aconcerned aabout ait.
b. can ahappen afrom aeating aa apoor adiet, aso achange awhat ayou aare aeating.
c. can ahappen afrom aarterial achanges athat aimpede athe ablood aflow.
d. happens awhen apeople ado anot aexercise, aso ayou ashould awalk aevery
aday.aANS: aC
Hardening aof athe aarteries afrom aatherosclerosis acan acause ahypertension ain athe apatient.
Hypertension adoes anot ahappen ato aeveryone. aChanging athe apatients adiet aand aexercising amay abe
aa apositive alife achange, abut athese aanswers ado anot aexplain ato athe apatient a how athe adisease acould
ahaveahappened.
3. The apatient aasks athe anurse ato aexplain athe asinoatrial anode ain athe aheart. aThe anurses abest
a responseawould a be, a The asinoatrial a node
a. provides athe aheart awith athe astimulation ato abeat ain aa anormal arhythm.
b. protects athe aheart afrom aatherosclerotic achanges.
c. provides athe aheart awith aoxygenated ablood.
d. protects athe aheart afrom ainfection.
aANS: a A
The asinoatrial anode ais athe anatural apacemaker aof athe aheart, aand ait aassists athe aheart ato abeat ain aa
normal arhythm. aThe asinoatrial anode adoes anot aprotect afrom aatherosclerotic achanges aor ainfection,
aand a it a does anot a directly aprovide athe aheart a with aoxygenated a blood.
4. The apatient a is abrought ato athe aemergency adepartment aafter aa amotor avehicle aaccident. aThe
apatientais adiagnosed a with ainternal ableeding. a The anurses aprimary aconcern a is ato amonitor a for
a. mental aalertness.
b. perfusion.
, c. pain.
d. reaction ato amedications.
aANS: a B
Perfusion ais athe acorrect aanswer, abecause awith ainternal ableeding, athe anurse ashould amonitor avital
signs ato abe asure aperfusion ais ahappening. aMental aalertness, apain, aand amedication areactions aare
aimportant a but a not a the a primary aconcern.
5. A apatients aserum aelectrolytes aare abeing amonitored. aThe anurse anotices athat athe apotassium
alevelais a low. a The a nurse aknows athat a the apatient a should a be aobserved a for
a. tissue aischemia.
b. brain amalformations.
c. intestinal ablockage.
d. cardiac adysthymia.
aANS: a D
Cardiac adysthymia a is aa apossibility awhen aserum apotassium ais ahigh aor alow. aTissue aischemia, abrain
malformations, aor aintestinal ablockage ado anot ahave aa adirect acorrelation ato apotassium airregularities.
6. A anurse ais aexplaining ato aa astudent anurse aabout aperfusion. aThe anurse aknows athe
astudentaunderstands athe aconcept a of aperfusion awhen a the astudent a states, aPerfusion
a. is aa anormal afunction aof athe abody, aand aI adont ahave ato abe aconcerned aabout ait.
b. is amonitored aby athe aphysician, aand aI ajust afollow aorders.
c. is amonitored aby avital asigns aand acapillary arefill.
d. varies aas aa aperson aages, aso aI awould aexpect achanges ain athe
abody.aANS: aC
The abest amethod ato amonitor aperfusion ais ato amonitor avital asigns aand acapillary arefill. aThis aallows
the anurse ato aknow aif aperfusion ais aadequate ato amaintain avital aorgans. aThe anurse adoes ahave ato abe
aconcerned aabout aperfusion. aPerfusion ais anot aonly amonitored aby athe aphysician abut a the anurse atoo.
aPerfusion adoes anot a always achange a as athe aperson aages.
7. The anurse ais aconducting aa apatient aassessment. aThe apatient atells athe anurse athat ahe ahas
asmokedatwo apacks aof acigarettes aper aday afor a27 ayears. a The anurse amay afind awhich adata aupon
aassessment?
a. Blood apressure aabove athe anormal arange
b. Bounding apedal apulses
c. Night ablindness
d. Reflux
adiseaseaANS: a A
Smokers ahave aa aconstriction aof athe ablood avessels adue ato athe atar aand anicotine ain acigarettes. aThis
constriction amay alead ato ahypertension. aBounding apulses, anight ablindness, aand areflux adisease ado
anot a have a a adirect a link a to asmoking.
Chapter a2.Gas aExchange
MULTIPLE aCHOICE
, 1. The anurse ais aassigned aa agroup aof apatients. aWhich apatient awould athe anurse aidentify aas abeing
aataincreased arisk a for aimpaired a gas aexchange? a A apatient
a. with aa ablood aglucose aof a350 amg/dL
b. who ahas abeen aon aanticoagulants afor a10 adays
c. with aa ahemoglobin aof a8.5 ag/dL
d. with aa aheart a rate aof a100 abeats/min aand ablood apressure aof
a100/60aANS: a C
The ahemoglobin ais alow a(anemia), atherefore athe aability aof athe ablood ato acarry aoxygen ais adecreased.
High ablood aglucose aand/or aanticoagulants ado anot aalter athe aoxygen acarrying acapacity aof athe
ablood.aA aheart a rate aof a100 abeats/min aand a blood apressure aof a100/60 aare anot a indicative aof aoxygen
acarryingacapacity aof athe a blood.
2. The anurse ais areviewing athe apatients aarterial ablood agas aresults. aThe aPaO2 ais a96 amm aHg, apH ais
a7.20, aPaCO2 ais a55 a mm aHg, aand aHCO3 ais a25 a mEq/L. a What a would athe anurse aexpect ato aobserve
aonaassessment a of athis apatient?
a. Disorientation aand atremors
b. Tachycardia aand adecreased ablood apressure
c. Increased aanxiety aand airritability
d. Hyperventilation aand alethargy
aANS: a A
The apatient ais aexperiencing arespiratory aacidosis a( a pH, aand a PaCO2 a) awhich amay abe
amanifested aby adisorientation, atremors, apossible aseizures, aand adecreased alevel aof aconsciousness.
aTachycardia aand adecreased ablood a pressure aare anot acharacteristic a of aa aproblem aof arespiratory
aacidosis.
Increased aanxiety aand ahyperventilation awill acause arespiratory aalkalosis, awhich ais amanifested aby
aan aincrease a in apH a and a a adecrease a in aPaCO2.
3. The anurse awould aidentify awhich apatient aas ahaving aa aproblem aof aimpaired agas
aexchangeasecondary ato a a aperfusion aproblem? a A apatient a with
a. peripheral aarterial adisease aof athe alower aextremities
b. chronic aobstructive apulmonary adisease a(COPD)
c. chronic aasthma
d. severe aanemia asecondary ato
achemotherapyaANS: a A
Perfusion arelates ato athe aability aof athe ablood ato adeliver aoxygen ato athe acellular a level aand areturn athe
carbon adioxide ato athe alung afor aremoval. aCOPD aand aasthma aare aexamples aof aa aventilation
aproblem. a Severe aanemia ais a an aexample aof aa atransport a problem aof agas aexchange.
4. The anurse ais aassessing aa apatients adifferential awhite ablood acell acount. aWhat aimplications
awouldathis atest a have aon aevaluating a the aadequacy aof aa apatients agas aexchange?
a. An aelevation aof athe atotal awhite acell acount aindicates ageneralized a inflammation.
b. Eosinophil acount awill aassist ato aidentify athe apresence aof aa arespiratory ainfection.
c. White acell acount awill adifferentiate atypes aof arespiratory abacteria.
d. Level aof aneutrophils aprovides aguidelines ato amonitor aa achronic ainfection.
a a a a
7th Edition Harding Snyder Test Bank
a a a a a a
, Clinical aReasoning aCases ain aNursing a7th aEdition aHarding aSnyder aTest aBank
Chapter a1.Perfusion
MULTIPLE aCHOICE
1. The anurse ais aexplaining ato aa astudent anurse aabout aimpaired acentral aperfusion. aThe anurse
aknowsathe astudent a understands athis aproblem awhen athe astudent a states, aCentral aperfusion
a. is amonitored aonly aby athe aphysician.
b. involves athe aentire abody.
c. is adecreased awith ahypertension.
d. is atoxic ato athe acardiac asystem.
aANS: a B
Central aperfusion adoes ainvolve athe aentire abody aas aall aorgans aare asupplied awith aoxygen aand avital
nutrients. aThe aphysician adoes anot acontrol athe abodys aability afor aperfusion. aCentral aperfusion ais
anotadecreased awith a hypertension. a Central aperfusion ais anot atoxic ato athe acardiac asystem.
2. A apatient awas adiagnosed awith ahypertension. aThe apatient aasks athe anurse ahow athis adisease
acouldahave ahappened ato athem. a The anurses a best a response a is aHypertension
a. happens ato aeveryone asooner aor alater. aDont abe aconcerned aabout ait.
b. can ahappen afrom aeating aa apoor adiet, aso achange awhat ayou aare aeating.
c. can ahappen afrom aarterial achanges athat aimpede athe ablood aflow.
d. happens awhen apeople ado anot aexercise, aso ayou ashould awalk aevery
aday.aANS: aC
Hardening aof athe aarteries afrom aatherosclerosis acan acause ahypertension ain athe apatient.
Hypertension adoes anot ahappen ato aeveryone. aChanging athe apatients adiet aand aexercising amay abe
aa apositive alife achange, abut athese aanswers ado anot aexplain ato athe apatient a how athe adisease acould
ahaveahappened.
3. The apatient aasks athe anurse ato aexplain athe asinoatrial anode ain athe aheart. aThe anurses abest
a responseawould a be, a The asinoatrial a node
a. provides athe aheart awith athe astimulation ato abeat ain aa anormal arhythm.
b. protects athe aheart afrom aatherosclerotic achanges.
c. provides athe aheart awith aoxygenated ablood.
d. protects athe aheart afrom ainfection.
aANS: a A
The asinoatrial anode ais athe anatural apacemaker aof athe aheart, aand ait aassists athe aheart ato abeat ain aa
normal arhythm. aThe asinoatrial anode adoes anot aprotect afrom aatherosclerotic achanges aor ainfection,
aand a it a does anot a directly aprovide athe aheart a with aoxygenated a blood.
4. The apatient a is abrought ato athe aemergency adepartment aafter aa amotor avehicle aaccident. aThe
apatientais adiagnosed a with ainternal ableeding. a The anurses aprimary aconcern a is ato amonitor a for
a. mental aalertness.
b. perfusion.
, c. pain.
d. reaction ato amedications.
aANS: a B
Perfusion ais athe acorrect aanswer, abecause awith ainternal ableeding, athe anurse ashould amonitor avital
signs ato abe asure aperfusion ais ahappening. aMental aalertness, apain, aand amedication areactions aare
aimportant a but a not a the a primary aconcern.
5. A apatients aserum aelectrolytes aare abeing amonitored. aThe anurse anotices athat athe apotassium
alevelais a low. a The a nurse aknows athat a the apatient a should a be aobserved a for
a. tissue aischemia.
b. brain amalformations.
c. intestinal ablockage.
d. cardiac adysthymia.
aANS: a D
Cardiac adysthymia a is aa apossibility awhen aserum apotassium ais ahigh aor alow. aTissue aischemia, abrain
malformations, aor aintestinal ablockage ado anot ahave aa adirect acorrelation ato apotassium airregularities.
6. A anurse ais aexplaining ato aa astudent anurse aabout aperfusion. aThe anurse aknows athe
astudentaunderstands athe aconcept a of aperfusion awhen a the astudent a states, aPerfusion
a. is aa anormal afunction aof athe abody, aand aI adont ahave ato abe aconcerned aabout ait.
b. is amonitored aby athe aphysician, aand aI ajust afollow aorders.
c. is amonitored aby avital asigns aand acapillary arefill.
d. varies aas aa aperson aages, aso aI awould aexpect achanges ain athe
abody.aANS: aC
The abest amethod ato amonitor aperfusion ais ato amonitor avital asigns aand acapillary arefill. aThis aallows
the anurse ato aknow aif aperfusion ais aadequate ato amaintain avital aorgans. aThe anurse adoes ahave ato abe
aconcerned aabout aperfusion. aPerfusion ais anot aonly amonitored aby athe aphysician abut a the anurse atoo.
aPerfusion adoes anot a always achange a as athe aperson aages.
7. The anurse ais aconducting aa apatient aassessment. aThe apatient atells athe anurse athat ahe ahas
asmokedatwo apacks aof acigarettes aper aday afor a27 ayears. a The anurse amay afind awhich adata aupon
aassessment?
a. Blood apressure aabove athe anormal arange
b. Bounding apedal apulses
c. Night ablindness
d. Reflux
adiseaseaANS: a A
Smokers ahave aa aconstriction aof athe ablood avessels adue ato athe atar aand anicotine ain acigarettes. aThis
constriction amay alead ato ahypertension. aBounding apulses, anight ablindness, aand areflux adisease ado
anot a have a a adirect a link a to asmoking.
Chapter a2.Gas aExchange
MULTIPLE aCHOICE
, 1. The anurse ais aassigned aa agroup aof apatients. aWhich apatient awould athe anurse aidentify aas abeing
aataincreased arisk a for aimpaired a gas aexchange? a A apatient
a. with aa ablood aglucose aof a350 amg/dL
b. who ahas abeen aon aanticoagulants afor a10 adays
c. with aa ahemoglobin aof a8.5 ag/dL
d. with aa aheart a rate aof a100 abeats/min aand ablood apressure aof
a100/60aANS: a C
The ahemoglobin ais alow a(anemia), atherefore athe aability aof athe ablood ato acarry aoxygen ais adecreased.
High ablood aglucose aand/or aanticoagulants ado anot aalter athe aoxygen acarrying acapacity aof athe
ablood.aA aheart a rate aof a100 abeats/min aand a blood apressure aof a100/60 aare anot a indicative aof aoxygen
acarryingacapacity aof athe a blood.
2. The anurse ais areviewing athe apatients aarterial ablood agas aresults. aThe aPaO2 ais a96 amm aHg, apH ais
a7.20, aPaCO2 ais a55 a mm aHg, aand aHCO3 ais a25 a mEq/L. a What a would athe anurse aexpect ato aobserve
aonaassessment a of athis apatient?
a. Disorientation aand atremors
b. Tachycardia aand adecreased ablood apressure
c. Increased aanxiety aand airritability
d. Hyperventilation aand alethargy
aANS: a A
The apatient ais aexperiencing arespiratory aacidosis a( a pH, aand a PaCO2 a) awhich amay abe
amanifested aby adisorientation, atremors, apossible aseizures, aand adecreased alevel aof aconsciousness.
aTachycardia aand adecreased ablood a pressure aare anot acharacteristic a of aa aproblem aof arespiratory
aacidosis.
Increased aanxiety aand ahyperventilation awill acause arespiratory aalkalosis, awhich ais amanifested aby
aan aincrease a in apH a and a a adecrease a in aPaCO2.
3. The anurse awould aidentify awhich apatient aas ahaving aa aproblem aof aimpaired agas
aexchangeasecondary ato a a aperfusion aproblem? a A apatient a with
a. peripheral aarterial adisease aof athe alower aextremities
b. chronic aobstructive apulmonary adisease a(COPD)
c. chronic aasthma
d. severe aanemia asecondary ato
achemotherapyaANS: a A
Perfusion arelates ato athe aability aof athe ablood ato adeliver aoxygen ato athe acellular a level aand areturn athe
carbon adioxide ato athe alung afor aremoval. aCOPD aand aasthma aare aexamples aof aa aventilation
aproblem. a Severe aanemia ais a an aexample aof aa atransport a problem aof agas aexchange.
4. The anurse ais aassessing aa apatients adifferential awhite ablood acell acount. aWhat aimplications
awouldathis atest a have aon aevaluating a the aadequacy aof aa apatients agas aexchange?
a. An aelevation aof athe atotal awhite acell acount aindicates ageneralized a inflammation.
b. Eosinophil acount awill aassist ato aidentify athe apresence aof aa arespiratory ainfection.
c. White acell acount awill adifferentiate atypes aof arespiratory abacteria.
d. Level aof aneutrophils aprovides aguidelines ato amonitor aa achronic ainfection.
