Test Banks For Clinical Reasoning Cases in Nursin
8th Edition by Mariann M. Harding;
Chapter 1 - 15
,Chapter 1. Perfusion
Clinical Reasoning Cases in Nursing 8th Edition Harding Snyder Test Bank
MULTIPLE CHOICE
1. The nurse is explaining to a student nurse about impaired central perfusion. The nurse knows
the student understands this problem when the student states, Central perfusion
a. Is monitored only by the physician.
b. Involves the entire body.
c. Is decreased with hypertension.
d. Is toxic to the cardiac system.
ANSWER: B
Central perfusion does involve the entire body as all organs are supplied with oxygen and vital
Nutrients. The physician does not control the bodys ability for perfusion. Central perfusion is
notdecreased with hypertension. Central perfusion is not toxic to the cardiac system.
2. A patient was diagnosed with hypertension. The patient asks the nurse how this disease could
have happened to them. The nurses best response is Hypertension
a. Happens to everyone sooner or later. Dont be concerned about it.
b. Can happen from eating a poor diet, so change what you are eating.
c. Can happen from arterial changes that impede the blood flow.
d. Happens when people do not exercise, so you should walk every
day.
ANSWER: C
Hardening of the arteries from atherosclerosis can cause hypertension in the patient.
Hypertension does not happen to everyone. Changing the patients diet and exercising may be a
positive life change, but these answers do not explain to the patient how the disease could have
happened.
3. The patient asks the nurse to explain the sinoatrial node in the heart. The nurses best response
would be, The sinoatrial node
a. Provides the heart with the stimulation to beat in a normal rhythm.
b. Protects the heart from atherosclerotic changes.
c. Provides the heart with oxygenated blood.
d. Protects the heart from
infection.
ANSWER: A
The sinoatrial node is the natural pacemaker of the heart, and it assists the heart to beat in a
Normal rhythm. The sinoatrial node does not protect from atherosclerotic changes or
infection,and it does not directly provide the heart with oxygenated blood.
4. The patient is brought to the emergency department after a motor vehicle accident. The patient
is diagnosed with internal bleeding. The nurses primary concern is to monitor for
a. Mental alertness.
, b. Perfusion.
c. Pain.
d. Reaction to
medications.
ANSWER: B
Perfusion is the correct answer, because with internal bleeding, the nurse should monitor vital
Signs to be sure perfusion is happening. Mental alertness, pain, and medication reactions
areimportant but not the primary concern.
5. A patients serum electrolytes are being monitored. The nurse notices that the potassium level
is low. The nurse knows that the patient should be observed for
a. Tissue ischemia.
b. Brain malformations.
c. Intestinal blockage.
d. Cardiac
dysthymia.
ANSWER: D
Cardiac dysthymia is a possibility when serum potassium is high or low. Tissue ischemia, brain
Malformations, or intestinal blockage do not have a direct correlation to potassium irregularities.
6. A nurse is explaining to a student nurse about perfusion. The nurse knows the student
understands the concept of perfusion when the student states, Perfusion
a. Is a normal function of the body, and I dont have to be concerned about it.
b. Is monitored by the physician, and I just follow orders.
c. Is monitored by vital signs and capillary refill.
d. Varies as a person ages, so I would expect changes in the
body.
ANSWER: C
The best method to monitor perfusion is to monitor vital signs and capillary refill. This allows
The nurse to know if perfusion is adequate to maintain vital organs. The nurse does have to be
concerned about perfusion. Perfusion is not only monitored by the physician but the nurse too.
Perfusion does not always change as the person ages.
7. The nurse is conducting a patient assessment. The patient tells the nurse that he has smoked
two packs of cigarettes per day for 27 years. The nurse may find which data upon assessment?
a. Blood pressure above the normal range
b. Bounding pedal pulses
c. Night blindness
, d. Reflux disease
ANSWER: A
Smokers have a constriction of the blood vessels due to the tar and nicotine in cigarettes. This
Constriction may lead to hypertension. Bounding pulses, night blindness, and reflux disease
donot have a direct link to smoking.
Chapter 2.Gas Exchange
MULTIPLE CHOICE
1. The tnurse tis tassigned ta tgroup tof tpatients. tWhich tpatient twould tthe tnurse tidentify tas tbeing
tat tincreased trisk tfor timpaired tgas texchange? tA tpatient
a. With ta tblood tglucose tof t350 tmg/dl
b. Who thas tbeen ton tanticoagulants tfor t10 tdays
c. With ta themoglobin tof t8.5 tg/dl
d. With ta theart trate tof t100 tbeats/min tand tblood tpressure
tof t100/60
ANSWER: tC
The themoglobin tis tlow t(anemia), ttherefore tthe tability tof tthe tblood tto tcarry toxygen tis
tdecreased. tHigh tblood tglucose tand/or tanticoagulants tdo tnot talter tthe toxygen tcarrying
tcapacity tof tthe tblood. tA theart trate tof t100 tbeats/min tand tblood tpressure tof t100/60 tare tnot
tindicative tof toxygen tcarrying tcapacity tof tthe tblood.
2. tThe tnurse tis treviewing tthe tpatients tarterial tblood tgas tresults. tThe tpao2 tis t96 tmm tHg, tph
tis t7.20, tpaco2 tis t55 tmm tHg, tand tHCO3 tis t25 tmeq/L. tWhat twould tthe tnurse texpect tto tobserve
ton tassessment tof tthis tpatient?
a. Disorientation tand ttremors
b. Tachycardia tand tdecreased tblood tpressure
c. Increased tanxiety tand tirritability
d. Hyperventilation tand tlethargy
ANSWER: tA
The tpatient tis texperiencing trespiratory tacidosis t( t ph, tand t paco2 t) twhich tmay tbe tmanifested
tby tdisorientation, ttremors, tpossible tseizures, tand tdecreased tlevel tof tconsciousness.
tTachycardia t and tdecreased tblood tpressure tare tnot tcharacteristic tof ta tproblem tof trespiratory
tacidosis.
Increased tanxiety tand thyperventilation twill tcause trespiratory talkalosis, twhich tis tmanifested
tby tan tincrease tin tph tand ta tdecrease tin tpaco2.
3. tThe tnurse twould tidentify twhich tpatient tas thaving ta tproblem tof timpaired tgas texchange
tsecondary tto ta tperfusion tproblem? tA tpatient twith
a. Peripheral tarterial tdisease tof tthe tlower textremities
b. Chronic tobstructive tpulmonary tdisease t(COPD)
8th Edition by Mariann M. Harding;
Chapter 1 - 15
,Chapter 1. Perfusion
Clinical Reasoning Cases in Nursing 8th Edition Harding Snyder Test Bank
MULTIPLE CHOICE
1. The nurse is explaining to a student nurse about impaired central perfusion. The nurse knows
the student understands this problem when the student states, Central perfusion
a. Is monitored only by the physician.
b. Involves the entire body.
c. Is decreased with hypertension.
d. Is toxic to the cardiac system.
ANSWER: B
Central perfusion does involve the entire body as all organs are supplied with oxygen and vital
Nutrients. The physician does not control the bodys ability for perfusion. Central perfusion is
notdecreased with hypertension. Central perfusion is not toxic to the cardiac system.
2. A patient was diagnosed with hypertension. The patient asks the nurse how this disease could
have happened to them. The nurses best response is Hypertension
a. Happens to everyone sooner or later. Dont be concerned about it.
b. Can happen from eating a poor diet, so change what you are eating.
c. Can happen from arterial changes that impede the blood flow.
d. Happens when people do not exercise, so you should walk every
day.
ANSWER: C
Hardening of the arteries from atherosclerosis can cause hypertension in the patient.
Hypertension does not happen to everyone. Changing the patients diet and exercising may be a
positive life change, but these answers do not explain to the patient how the disease could have
happened.
3. The patient asks the nurse to explain the sinoatrial node in the heart. The nurses best response
would be, The sinoatrial node
a. Provides the heart with the stimulation to beat in a normal rhythm.
b. Protects the heart from atherosclerotic changes.
c. Provides the heart with oxygenated blood.
d. Protects the heart from
infection.
ANSWER: A
The sinoatrial node is the natural pacemaker of the heart, and it assists the heart to beat in a
Normal rhythm. The sinoatrial node does not protect from atherosclerotic changes or
infection,and it does not directly provide the heart with oxygenated blood.
4. The patient is brought to the emergency department after a motor vehicle accident. The patient
is diagnosed with internal bleeding. The nurses primary concern is to monitor for
a. Mental alertness.
, b. Perfusion.
c. Pain.
d. Reaction to
medications.
ANSWER: B
Perfusion is the correct answer, because with internal bleeding, the nurse should monitor vital
Signs to be sure perfusion is happening. Mental alertness, pain, and medication reactions
areimportant but not the primary concern.
5. A patients serum electrolytes are being monitored. The nurse notices that the potassium level
is low. The nurse knows that the patient should be observed for
a. Tissue ischemia.
b. Brain malformations.
c. Intestinal blockage.
d. Cardiac
dysthymia.
ANSWER: D
Cardiac dysthymia is a possibility when serum potassium is high or low. Tissue ischemia, brain
Malformations, or intestinal blockage do not have a direct correlation to potassium irregularities.
6. A nurse is explaining to a student nurse about perfusion. The nurse knows the student
understands the concept of perfusion when the student states, Perfusion
a. Is a normal function of the body, and I dont have to be concerned about it.
b. Is monitored by the physician, and I just follow orders.
c. Is monitored by vital signs and capillary refill.
d. Varies as a person ages, so I would expect changes in the
body.
ANSWER: C
The best method to monitor perfusion is to monitor vital signs and capillary refill. This allows
The nurse to know if perfusion is adequate to maintain vital organs. The nurse does have to be
concerned about perfusion. Perfusion is not only monitored by the physician but the nurse too.
Perfusion does not always change as the person ages.
7. The nurse is conducting a patient assessment. The patient tells the nurse that he has smoked
two packs of cigarettes per day for 27 years. The nurse may find which data upon assessment?
a. Blood pressure above the normal range
b. Bounding pedal pulses
c. Night blindness
, d. Reflux disease
ANSWER: A
Smokers have a constriction of the blood vessels due to the tar and nicotine in cigarettes. This
Constriction may lead to hypertension. Bounding pulses, night blindness, and reflux disease
donot have a direct link to smoking.
Chapter 2.Gas Exchange
MULTIPLE CHOICE
1. The tnurse tis tassigned ta tgroup tof tpatients. tWhich tpatient twould tthe tnurse tidentify tas tbeing
tat tincreased trisk tfor timpaired tgas texchange? tA tpatient
a. With ta tblood tglucose tof t350 tmg/dl
b. Who thas tbeen ton tanticoagulants tfor t10 tdays
c. With ta themoglobin tof t8.5 tg/dl
d. With ta theart trate tof t100 tbeats/min tand tblood tpressure
tof t100/60
ANSWER: tC
The themoglobin tis tlow t(anemia), ttherefore tthe tability tof tthe tblood tto tcarry toxygen tis
tdecreased. tHigh tblood tglucose tand/or tanticoagulants tdo tnot talter tthe toxygen tcarrying
tcapacity tof tthe tblood. tA theart trate tof t100 tbeats/min tand tblood tpressure tof t100/60 tare tnot
tindicative tof toxygen tcarrying tcapacity tof tthe tblood.
2. tThe tnurse tis treviewing tthe tpatients tarterial tblood tgas tresults. tThe tpao2 tis t96 tmm tHg, tph
tis t7.20, tpaco2 tis t55 tmm tHg, tand tHCO3 tis t25 tmeq/L. tWhat twould tthe tnurse texpect tto tobserve
ton tassessment tof tthis tpatient?
a. Disorientation tand ttremors
b. Tachycardia tand tdecreased tblood tpressure
c. Increased tanxiety tand tirritability
d. Hyperventilation tand tlethargy
ANSWER: tA
The tpatient tis texperiencing trespiratory tacidosis t( t ph, tand t paco2 t) twhich tmay tbe tmanifested
tby tdisorientation, ttremors, tpossible tseizures, tand tdecreased tlevel tof tconsciousness.
tTachycardia t and tdecreased tblood tpressure tare tnot tcharacteristic tof ta tproblem tof trespiratory
tacidosis.
Increased tanxiety tand thyperventilation twill tcause trespiratory talkalosis, twhich tis tmanifested
tby tan tincrease tin tph tand ta tdecrease tin tpaco2.
3. tThe tnurse twould tidentify twhich tpatient tas thaving ta tproblem tof timpaired tgas texchange
tsecondary tto ta tperfusion tproblem? tA tpatient twith
a. Peripheral tarterial tdisease tof tthe tlower textremities
b. Chronic tobstructive tpulmonary tdisease t(COPD)
