TEST BANK @ q
CLINICAL REASONING CASE
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S IN NURSING,
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7TH EDITION @q
BY HARDING| SNYDER
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TEST BANK @ q
,Chapter 1. Perfusion @q @q
Clinical Reasoning Cases in Nursing 7th Edition Harding Snyder Test Bank
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MULTIPLE CHOICE @q
1. The nurse is explaining to a student nurse about impaired central perfusion. The nurse
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knows the student understands this problem when the student states, Central perfusion
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a. Is monitored only by the physician.@q @q @q @q @q
b. Involves the entire body. @q @q @q
c. Is decreased with hypertension.
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d. Is toxic to the cardiac system.
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ANS: B @q
Central perfusion does involve the entire body as all organs are supplied with oxygen and
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vital Nutrients. The physician does not control the bodys ability for perfusion. Central
@q @q @q @q @q @q @q @q @q @q @q @q @q @q
perfusion is not decreased with hypertension. Central perfusion is not toxic to the cardia
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c system.
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2. A patient was diagnosed with hypertension. The patient asks the nurse how this diseas
@q @q @q @q @q @q @q @q @q @q @q @q @q @q
e could 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.
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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 e
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very day. @q
ANS: C @q
Hardening of the arteries from atherosclerosis can cause hypertension in the patient. Hyp
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ertension does not happen to everyone. Changing the patients diet and exercising may be
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a positive life change, but these answers do not explain to the patient how the disease c
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ould have happened.
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3. The patient asks the nurse to explain the sinoatrial node in the heart. The nurses best
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response would be, The sinoatrial node
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a. Provides the heart with the stimulation to beat in a normal rhythm.
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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 fro @q @q @q
m infection.
@q
ANS: A @q
The sinoatrial node is the natural pacemaker of the heart, and it assists the heart to
@q @q @q @q @q @q @q @q @q @q @q @q @q @q @q @q
beat in a Normal rhythm. The sinoatrial node does not protect from atherosclerotic
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changes or infection, and it does not directly provide the heart with oxygenated blo
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od.
,4. The patient is brought to the emergency department after a motor vehicle accident. The
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patient is diagnosed with internal bleeding. The nurses primary concern is to monitor for
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a. Mental alertness. @q
b. Perfusion.
c. Pain.
d.
Reaction t @q
o medications. ANS:
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B
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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 reacti
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ons 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
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level is low. The nurse knows that the patient should be observed for
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a. Tissue ischemia. @q
b. Brain malformations.
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c. Intestinal blockage. @q
d.
Cardiac
@q dysthymia.
ANS: D @q
Cardiac dysthymia is a possibility when serum potassium is high or low. Tissue ischemia, brain M
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alformations, 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
@q @q @q @q @q @q @q @q @q @q @q @q @q @q @q @
understands 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 i
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n the body.
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ANS: C @q
The best method to monitor perfusion is to monitor vital signs and capillary refill. This
@q @q @q @q @q @q @q @q @q @q @q @q @q @q
allows The nurse to know if perfusion is adequate to maintain vital organs. The nurse
@q @q @q @q @q @q @q @q @q @q @q @q @q @q @q
does have to be concerned about perfusion. Perfusion is not only monitored by the ph
@q @q @q @q @q @q @q @q @q @q @q @q @q @q @q
ysician but the nurse too. Perfusion does not always change as the person ages.
@q @q @q @q @q @q @q @q @q @q @q @q @q
7. The nurse is conducting a patient assessment. The patient tells the nurse that he has
@q @q @q @q @q @q @q @q @q @q @q @q @q @q @q @q
smoked two packs of cigarettes per day for 27 years. The nurse may find which data u
@q @q @q @q @q @q @q @q @q @q @q @q @q @q @q @q
pon assessment?
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a. Blood pressure above the normal range @q @q @q @q @q
b. Bounding pedal pulses @q @q
c. Night blindness @q
d. Reflux disease @q
e. ANS: A @q
Smokers have a constriction of the blood vessels due to the tar and nicotine in cigarett
@q @q @q @q @q @q @q @q @q @q @q @q @q @q @q
es. This Constriction may lead to hypertension. Bounding pulses, night blindness, and
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reflux disease do not have a direct link to smoking.
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Chapter 2.Gas Exchange MU @q @q @q
LTIPLE CHOICE @q
1. The nurse is assigned a group of patients. Which patient would the nurse identify as b
@q @q @q @q @q @q @q @q @q @q @q @q @q @q @q @q
eing at increased risk for impaired gas exchange? A patient
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a. With a blood glucose of 350 mg/dl @q @q @q @q @q @q
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 pressu
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re of 100/60
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ANS: C @q
The hemoglobin is low (anemia), therefore the ability of the blood to carry oxygen is de
@q @q @q @q @q @q @q @q @q @q @q @q @q @q @q
creased. High blood glucose and/or anticoagulants do not alter the oxygen carrying capacit
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y of the blood. A heart rate of 100 beats/min and blood pressure of 100/60 are not indica
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tive of oxygen carrying 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
@q @q @q @q @q @q @q @q @q @q @q @q @q @q @q @q @q @q
7.20, paco2 is 55 mm Hg, and HCO3 is 25 meq/L. What would the nurse expect to obs
@q @q @q @q @q @q @q @q @q @q @q @q @q @q @q @q @q
erve on assessment of this patient?
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a. Disorientation and tremors @q @q
CLINICAL REASONING CASE
@q @q
S IN NURSING,
@ q @ q
7TH EDITION @q
BY HARDING| SNYDER
@q @q
TEST BANK @ q
,Chapter 1. Perfusion @q @q
Clinical Reasoning Cases in Nursing 7th Edition Harding Snyder Test Bank
@q @q @q @q @q @q @q @q @q @q
MULTIPLE CHOICE @q
1. The nurse is explaining to a student nurse about impaired central perfusion. The nurse
@q @q @q @q @q @q @q @q @q @q @q @q @q @q @q
knows the student understands this problem when the student states, Central perfusion
@q @q @q @q @q @q @q @q @q @q @q
a. Is monitored only by the physician.@q @q @q @q @q
b. Involves the entire body. @q @q @q
c. Is decreased with hypertension.
@q @q @q
d. Is toxic to the cardiac system.
@q @q @q @q @q
ANS: B @q
Central perfusion does involve the entire body as all organs are supplied with oxygen and
@q @q @q @q @q @q @q @q @q @q @q @q @q @q
vital Nutrients. The physician does not control the bodys ability for perfusion. Central
@q @q @q @q @q @q @q @q @q @q @q @q @q @q
perfusion is not decreased with hypertension. Central perfusion is not toxic to the cardia
@q @q @q @q @q @q @q @q @q @q @q @q @q
c system.
@q
2. A patient was diagnosed with hypertension. The patient asks the nurse how this diseas
@q @q @q @q @q @q @q @q @q @q @q @q @q @q
e could have happened to them. The nurses best response is Hypertension
@q @q @q @q @q @q @q @q @q @q @q
a. Happens to everyone sooner or later. Dont be concerned about it.
@q @q @q @q @q @q @q @q @q @q
b. Can happen from eating a poor diet, so change what you are eating.
@q @q @q @q @q @q @q @q @q @q @q @q
c. Can happen from arterial changes that impede the blood flow.
@q @q @q @q @q @q @q @q @q
d.
Happens when people do not exercise, so you should walk e
@q @q @q @q @q @q @q @q @q @q
very day. @q
ANS: C @q
Hardening of the arteries from atherosclerosis can cause hypertension in the patient. Hyp
@q @q @q @q @q @q @q @q @q @q @q @q
ertension does not happen to everyone. Changing the patients diet and exercising may be
@q @q @q @q @q @q @q @q @q @q @q @q @q @
a positive life change, but these answers do not explain to the patient how the disease c
q @q @q @q @q @q @q @q @q @q @q @q @q @q @q @q @q
ould have happened.
@q @q
3. The patient asks the nurse to explain the sinoatrial node in the heart. The nurses best
@q @q @q @q @q @q @q @q @q @q @q @q @q @q @q @q @q
response would be, The sinoatrial node
@q @q @q @q @q
a. Provides the heart with the stimulation to beat in a normal rhythm.
@q @q @q @q @q @q @q @q @q @q @q
b. Protects the heart from atherosclerotic changes.
@q @q @q @q @q
c. Provides the heart with oxygenated blood.
@q @q @q @q @q
d.
Protects the heart fro @q @q @q
m infection.
@q
ANS: A @q
The sinoatrial node is the natural pacemaker of the heart, and it assists the heart to
@q @q @q @q @q @q @q @q @q @q @q @q @q @q @q @q
beat in a Normal rhythm. The sinoatrial node does not protect from atherosclerotic
@q @q @q @q @q @q @q @q @q @q @q @q @q
changes or infection, and it does not directly provide the heart with oxygenated blo
@q @q @q @q @q @q @q @q @q @q @q @q @q
od.
,4. The patient is brought to the emergency department after a motor vehicle accident. The
@q @q @q @q @q @q @q @q @q @q @q @q @q @q @q
patient is diagnosed with internal bleeding. The nurses primary concern is to monitor for
@q @q @q @q @q @q @q @q @q @q @q @q @q
a. Mental alertness. @q
b. Perfusion.
c. Pain.
d.
Reaction t @q
o medications. ANS:
@q @q
B
@q
Perfusion is the correct answer, because with internal bleeding, the nurse should monitor vital
@q @q @q @q @q @q @q @q @q @q @q @q @q
Signs to be sure perfusion is happening. Mental alertness, pain, and medication reacti
@q @q @q @q @q @q @q @q @q @q @q @q
ons are important but not the primary concern.
@q @q @q @q @q @q @q
5. A patients serum electrolytes are being monitored. The nurse notices that the potassium
@q @q @q @q @q @q @q @q @q @q @q @q @q
level is low. The nurse knows that the patient should be observed for
@q @q @q @q @q @q @q @q @q @q @q @q @q
a. Tissue ischemia. @q
b. Brain malformations.
@q
c. Intestinal blockage. @q
d.
Cardiac
@q dysthymia.
ANS: D @q
Cardiac dysthymia is a possibility when serum potassium is high or low. Tissue ischemia, brain M
@q @q @q @q @q @q @q @q @q @q @q @q @q @q @q
alformations, or intestinal blockage do not have a direct correlation to potassium irregularities.
@q @q @q @q @q @q @q @q @q @q @q @q
6. A nurse is explaining to a student nurse about perfusion. The nurse knows the student
@q @q @q @q @q @q @q @q @q @q @q @q @q @q @q @
understands the concept of perfusion when the student states, Perfusion
q @q @q @q @q @q @q @q @q @q
a. Is a normal function of the body, and I dont have to be concerned about it.
@q @q @q @q @q @q @q @q @q @q @q @q @q @q @q
b. Is monitored by the physician, and I just follow orders.
@q @q @q @q @q @q @q @q @q
c. Is monitored by vital signs and capillary refill.
@q @q @q @q @q @q @q
, d.
Varies as a person ages, so I would expect changes i
@q @q @q @q @q @q @q @q @q @q
n the body.
@q @q
ANS: C @q
The best method to monitor perfusion is to monitor vital signs and capillary refill. This
@q @q @q @q @q @q @q @q @q @q @q @q @q @q
allows The nurse to know if perfusion is adequate to maintain vital organs. The nurse
@q @q @q @q @q @q @q @q @q @q @q @q @q @q @q
does have to be concerned about perfusion. Perfusion is not only monitored by the ph
@q @q @q @q @q @q @q @q @q @q @q @q @q @q @q
ysician but the nurse too. Perfusion does not always change as the person ages.
@q @q @q @q @q @q @q @q @q @q @q @q @q
7. The nurse is conducting a patient assessment. The patient tells the nurse that he has
@q @q @q @q @q @q @q @q @q @q @q @q @q @q @q @q
smoked two packs of cigarettes per day for 27 years. The nurse may find which data u
@q @q @q @q @q @q @q @q @q @q @q @q @q @q @q @q
pon assessment?
@q
a. Blood pressure above the normal range @q @q @q @q @q
b. Bounding pedal pulses @q @q
c. Night blindness @q
d. Reflux disease @q
e. ANS: A @q
Smokers have a constriction of the blood vessels due to the tar and nicotine in cigarett
@q @q @q @q @q @q @q @q @q @q @q @q @q @q @q
es. This Constriction may lead to hypertension. Bounding pulses, night blindness, and
@q @q @q @q @q @q @q @q @q @q @q @q
reflux disease do not have a direct link to smoking.
@q @q @q @q @q @q @q @q @q
Chapter 2.Gas Exchange MU @q @q @q
LTIPLE CHOICE @q
1. The nurse is assigned a group of patients. Which patient would the nurse identify as b
@q @q @q @q @q @q @q @q @q @q @q @q @q @q @q @q
eing at increased risk for impaired gas exchange? A patient
@q @q @q @q @q @q @q @q @q
a. With a blood glucose of 350 mg/dl @q @q @q @q @q @q
b. Who has been on anticoagulants for 10 days
@q @q @q @q @q @q @q
c. With a hemoglobin of 8.5 g/dl
@q @q @q @q @q
d.
With a heart rate of 100 beats/min and blood pressu
@q @q @q @q @q @q @q @q @q
re of 100/60
@q @q
ANS: C @q
The hemoglobin is low (anemia), therefore the ability of the blood to carry oxygen is de
@q @q @q @q @q @q @q @q @q @q @q @q @q @q @q
creased. High blood glucose and/or anticoagulants do not alter the oxygen carrying capacit
@q @q @q @q @q @q @q @q @q @q @q @q
y of the blood. A heart rate of 100 beats/min and blood pressure of 100/60 are not indica
@q @q @q @q @q @q @q @q @q @q @q @q @q @q @q @q @q
tive of oxygen carrying capacity of the blood.
@q @q @q @q @q @q @q
2. The nurse is reviewing the patients arterial blood gas results. The pao2 is 96 mm Hg, ph is
@q @q @q @q @q @q @q @q @q @q @q @q @q @q @q @q @q @q
7.20, paco2 is 55 mm Hg, and HCO3 is 25 meq/L. What would the nurse expect to obs
@q @q @q @q @q @q @q @q @q @q @q @q @q @q @q @q @q
erve on assessment of this patient?
@q @q @q @q @q
a. Disorientation and tremors @q @q
