Test Bank For Clinical Reasoning Cases in Nursing 7th Edition By Mariann M. Harding; Julie S. Snyder 9780323527361 Chapter 1-15 Complete Guide .

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CLINICAL REASONING CASE
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S IN NURSING,
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7TH EDITION
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BY HARDING| SNYDER
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TEST BANK @

,Chapter 1. Perfusion @ @



Clinical Reasoning Cases in Nursing 7th Edition Harding Snyder Test Bank
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MULTIPLE CHOICE @


1. The nurse is explaining to a student nurse about impaired central perfusion. The nurse know
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s the student understands this problem when the student states, Central perfusion
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a. Is monitored only by the physician. @ @ @ @ @



b. Involves the entire body. @ @ @



c. Is decreased with hypertension.
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d. Is toxic to the cardiac system.
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ANS: B @


Central perfusion does involve the entire body as all organs are supplied with oxygen and vital
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Nutrients. The physician does not control the bodys ability for perfusion. Central perfusion is
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not decreased with hypertension. Central perfusion is not toxic to the cardiac system.
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2. A patient was diagnosed with hypertension. The patient asks the nurse how this disease cou
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ld have 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. @ @ @ @ @ @ @ @ @ @



b. Can happen from eating a poor diet, so change what you are eating.
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c. Can happen from arterial changes that impede the blood flow.
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d.
Happens when people do not exercise, so you should walk ever
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y day.
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ANS: C @


Hardening of the arteries from atherosclerosis can cause hypertension in the patient. Hyperten
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sion does not happen to everyone. Changing the patients diet and exercising may be a positive
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@life change, but these answers do not explain to the patient how the disease could have happe
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ned.

3. The patient asks the nurse to explain the sinoatrial node in the heart. The nurses best respon
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se would be, The sinoatrial node
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a. Provides the heart with the stimulation to beat in a normal rhythm. @ @ @ @ @ @ @ @ @ @ @



b. Protects the heart from atherosclerotic changes.
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c. Provides the heart with oxygenated blood.
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d.
Protects the heart from @ @ @



infection.
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ANS: A @


The sinoatrial node is the natural pacemaker of the heart, and it assists the heart to beat i
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n a Normal rhythm. The sinoatrial node does not protect from atherosclerotic changes or
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@infection, and it does not directly provide the heart with oxygenated blood.
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4. The patient is brought to the emergency department after a motor vehicle accident. The patie
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nt is diagnosed with internal bleeding. The nurses primary concern is to monitor for
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, a. Mental alertness. @


b. Perfusion.




c. Pain.
d.
Reaction to @



@medications. ANS: B @ @


Perfusion is the correct answer, because with internal bleeding, the nurse should monitor vital
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Signs to be sure perfusion is happening. Mental alertness, pain, and medication reactions
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are important but not the primary concern.
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5. A patients serum electrolytes are being monitored. The nurse notices that the potassium lev
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el is low. The nurse knows that the patient should be observed for
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a. Tissue ischemia. @



b. Brain malformations.@



c. Intestinal blockage. @



d.
Cardiac
dysthymia.
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ANS: D @


Cardiac dysthymia is a possibility when serum potassium is high or low. Tissue ischemia, brain Malform
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ations, or intestinal blockage do not have a direct correlation to potassium irregularities.
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6. A nurse is explaining to a student nurse about perfusion. The nurse knows the student unde
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rstands the 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.
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b. Is monitored by the physician, and I just follow orders.
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c. Is monitored by vital signs and capillary refill.
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d.
Varies as a person ages, so I would expect changes in th
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e body.
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ANS: C @


The best method to monitor perfusion is to monitor vital signs and capillary refill. This allo
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ws The nurse to know if perfusion is adequate to maintain vital organs. The nurse does have
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@to be concerned about perfusion. Perfusion is not only monitored by the physician but the n
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urse too. Perfusion does 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 smok
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ed two packs of cigarettes per day for 27 years. The nurse may find which data upon assess
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ment?
a. Blood pressure above the normal range @ @ @ @ @



b. Bounding pedal pulses @ @



c. Night blindness @

, d. Reflux disease @




e. ANS: A @


Smokers have a constriction of the blood vessels due to the tar and nicotine in cigarettes. Th
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is Constriction may lead to hypertension. Bounding pulses, night blindness, and reflux disea
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se do not have a direct link to smoking.
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Chapter 2.Gas Exchange MUL @ @ @




TIPLE CHOICE @


1. The nurse is assigned a group of patients. Which patient would the nurse identify as being a
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t increased risk for impaired gas exchange? A patient
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a. With a blood glucose of 350 mg/dl @ @ @ @ @ @



b. Who has been on anticoagulants for 10 days
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c. With a hemoglobin of 8.5 g/dl
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d.
With a heart rate of 100 beats/min and blood pressure
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of 100/60
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ANS: C @


The hemoglobin is low (anemia), therefore the ability of the blood to carry oxygen is decrease
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d. High blood glucose and/or anticoagulants do not alter the oxygen carrying capacity of the bl
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ood. A heart rate of 100 beats/min and blood pressure of 100/60 are not indicative of oxygen c
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arrying capacity of the blood.
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2. The nurse is reviewing the patients arterial blood gas results. The pao2 is 96 mm Hg, ph is
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7.20, paco2 is 55 mm Hg, and HCO3 is 25 meq/L. What would the nurse expect to observe o
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n assessment of this patient?
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a. Disorientation and tremors @ @



b. Tachycardia and decreased blood pressure @ @ @ @



c. Increased anxiety and irritability @ @ @



d. Hyperventilation and lethargy @ @




ANS: A @




The patient is experiencing respiratory acidosis ( ph, and paco2 ) which may be manifested by
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@disorientation, tremors, possible seizures, and decreased level of consciousness. Tachycard
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ia and decreased blood pressure are not characteristic of a problem of respiratory acidosis.
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Increased anxiety and hyperventilation will cause respiratory alkalosis, which is manifested by
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@an increase in ph and a decrease in paco2.
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3. The nurse would identify which patient as having a problem of impaired gas exchange seco
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ndary to a perfusion problem? A patient with
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a. Peripheral arterial disease of the lower extremities @ @ @ @ @ @



b. Chronic obstructive pulmonary disease (COPD)
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