Chapter 10: Cardiovascular Disorders
1. Mrs. M. W. comes into the primary care office for her regular yearly checkup. The nurse practitioner
begins the assessment by asking if there are concerns Mrs. M. W. has that need to be addressed. The
patient says that she has been experiencing periodic episodes of abdominal cramps and diarrhea that
just comes and goes. The nurse practitioner continues the assessment with which of the following?
1. Asking about the sequence of events and events that triggered each episode.
2. Conducting a complete neurological examination.
3. Collecting a urine specimen.
4. Evaluating abdominal pain. - 1. Answer: 1
Page: 225
Feedback
1.
Determining the sequence of events that triggered each symptom and inquiring about precipitating
factors such as a meal, position of the body, use of caffeine, or alcohol and smoking will lead to a
differential diagnosis.
2.
Information regarding episodes of anorexia, dyspepsia, dysphagia, heartburn, nausea, regurgitation,
vomiting, painful or difficult defecation, diarrhea, tenesmus, or constipation can be clustered to form a
differential diagnosis.
3.
The physical examination is often unremarkable, and laboratory findings may not provide diagnostic
information because the presentation of illness in an older adult is usually subdued.
4.
Ask about the severity of pain by having the patient rate her pain on a scale of 1 to 10. Realize,
however, that in older adults, pain may be blunted despite the underlying pathology.
2. Part of the abdominal examination the nurse practitioner will conduct is the assessment of skin
color. As the nurse practitioner assesses the abdominal skin, the findings include which of these signs
that are concerning?
1. Generalized pinkness.
2. Bluish discoloration on the flanks.
3. Yellow tint around the lower left quadrant.
4. Blue in the upper left quadrant. - 2. Answer: 2
Page: 226
Feedback
1.
, Pinkness is normal for a Caucasian patient.
2.
If the bluish discoloration is on the flanks, this is known as Grey Turner's sign and is often indicative
of retroperitoneal bleeding, as with pancreatitis.
3.
Jaundice in the area of the umbilicus is known as Ransohoff's sign and is a result of a ruptured
common bile duct.
4.
If a bluish discoloration is detected around the umbilicus, this is known as Cullen's sign, which is often
found in patients with bleeding in the peritoneum.
1. Mrs. M. W. comes into the primary care office for her regular yearly checkup. The nurse practitioner
begins the assessment by asking if there are concerns Mrs. M. W. has that need to be addressed. The
patient says that she has been experiencing periodic episodes of abdominal cramps and diarrhea that
just comes and goes. The nurse practitioner continues the assessment with which of the following?
1. Asking about the sequence of events and events that triggered each episode.
2. Conducting a complete neurological examination.
3. Collecting a urine specimen.
4. Evaluating abdominal pain. - 1. Answer: 1
Page: 225
Feedback
1.
Determining the sequence of events that triggered each symptom and inquiring about precipitating
factors such as a meal, position of the body, use of caffeine, or alcohol and smoking will lead to a
differential diagnosis.
2.
Information regarding episodes of anorexia, dyspepsia, dysphagia, heartburn, nausea, regurgitation,
vomiting, painful or difficult defecation, diarrhea, tenesmus, or constipation can be clustered to form a
differential diagnosis.
3.
The physical examination is often unremarkable, and laboratory findings may not provide diagnostic
information because the presentation of illness in an older adult is usually subdued.
4.
Ask about the severity of pain by having the patient rate her pain on a scale of 1 to 10. Realize,
however, that in older adults, pain may be blunted despite the underlying pathology.
2. Part of the abdominal examination the nurse practitioner will conduct is the assessment of skin
color. As the nurse practitioner assesses the abdominal skin, the findings include which of these signs
that are concerning?
1. Generalized pinkness.
2. Bluish discoloration on the flanks.
3. Yellow tint around the lower left quadrant.
4. Blue in the upper left quadrant. - 2. Answer: 2
Page: 226
Feedback
1.
, Pinkness is normal for a Caucasian patient.
2.
If the bluish discoloration is on the flanks, this is known as Grey Turner's sign and is often indicative
of retroperitoneal bleeding, as with pancreatitis.
3.
Jaundice in the area of the umbilicus is known as Ransohoff's sign and is a result of a ruptured
common bile duct.
4.
If a bluish discoloration is detected around the umbilicus, this is known as Cullen's sign, which is often
found in patients with bleeding in the peritoneum.
