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