LMS Multi-Choice, "The Game" & SDLP Flashcards
The patient asks the nurse what function the tonsils serve. Which of the following would be the most accurate response?
a. The tonsils aid digestion
b. The tonsils help to guard the body from invasion of organisms
c. The tonsils contain nerves that provoke sneezing
d. The tonsils regulate the airflow to the bronchi
e. The tonsils serve no known physiological purpose
b. The tonsils help to guard the body from invasion of organisms
The nurse is caring for a patient who has just returned to the unit after a colon resection. The patient is showing signs of hypoxia.
The nurse knows that this is probably caused by what?
a. Diffusion
b. Interbalance
c. Perfusion
d. Shunting
e. Incorrect application of the oxygen saturation probe
d. Shunting
You are caring for a patient admitted with chronic obstructive pulmonary disease. During your shift assessment, you find that your patient is experiencing a change in his respiratory and mental status.
You are aware that the most accurate measurement of the concentration of oxygen in the patient’s blood is what?
a. A capillary blood sample
b. Pulse oximetry
c. An arterial blood gas study
d. Assessment of the patient’s nailbeds
e. Lung field auscultation
c. An arterial blood gas study
You are the nurse working on the respiratory intensive care unit. You are aware that several respiratory conditions can affect the compliance of the lung tissue. Which condition leads to an increase in lung compliance?
a. Emphysema
b. Pulmonary fibrosis
c. Pleural effusion
d. ARDS
e. Bronchitis
a. Emphysema
Your patient has multiple sclerosis. Neuromuscular disorders such as multiple sclerosis may lead to a decreased vital capacity. What does vital capacity measure?
a. The volume of air inhaled and exhaled with each breath
b. The volume of air in the lungs after a maximum inspiration
c. The maximum volume of air inhaled after normal expiration
d. The maximum volume of air exhaled from the point of maximum inspiration
e. The maximum volume of air exhaled after a maximum expiration
d. The maximum volume of air exhaled from the point of maximum inspiration
The instructor of the physiology class for pre-nursing students is talking about the lower respiratory tract. The instructor talks about the visceral and parietal pleura and the small amount of fluid between the two membranes. What does the instructor tell her students the function of the pleura and the pleural fluid is?
a. Allows for full expansion of the lungs within
the thoracic cavity
b. Prevents the lungs from collapsing within the
thoracic cavity
c. Determines lung expansion within the thoracic
cavity
d. Permits smooth motion of the lungs within the thoracic
cavity
e. None of the above
d. Permits smooth motion of the lungs within the thoracic
cavity
You are caring for a patient with a lower respiratory tract infection. You know that this type of infection causes what?
a. Impaired gas exchange
b. Collapsed bronchial structures
c. Ruptured blebs
d. Closed bronchial tree
e. Sputum production
a. Impaired gas exchange
You are working on a gerontology unit. You admit a 77-year-old with respiratory problems. You know that the amount of respiratory dead space increases with age.
What do these changes result in?
a. Increased diffusion of gases
b. Decreased diffusion capacity for oxygen
c. Decreased shunting of blood
d. Increased ventilation
e. Increased perfusion
b. Decreased diffusion capacity for oxygen
Your patient has just had an MRI ordered because a routine chest x-ray showed suspicious areas in the right lung. The physician suspects bronchogenic carcinoma.
You would know that an MRI would assess for what in this patient?
a. Patency of the bronchial tree
b. To evaluate inflammatory activity
c. Ability to expand the lung
d. Chest wall invasion
e. Shunting of the blood supply
d. Chest wall invasion
You are caring for a patient with chronic obstructive pulmonary disease. When you auscultate this patient’s breath sounds, what do you expect to hear?
a. Continuous popping sounds early in inspiration
b. Harsh, dry sounds originating in the large bronchi
c. Discontinuous popping sounds heard in early inspiration
d. Soft, high-pitched, popping sounds that occur during inspiration
e. snap crackle and pop just like Rice Bubbles
a. Continuous popping sounds early in inspiration
The nursing instructor is explaining cardiac function to the senior nursing class. The instructor explains that blood is ejected into circulation as the chambers of the heart become smaller. The instructor categorises this action of the heart as what?
a. hyptertension
b. ejection fraction
c. systole
d. terminal volume
e. diastole
c. systole
The nurse is caring for a patient with unstable angina. The laboratory result for the initial troponin I is elevated in this patient. The nurse recognises what?
a. It is not an accurate indicator of anything
b. Because the entry diagnosis is unstable angina this is a poor indicator of myocardial injury
c. This is only an accurate indicator of myocardial damage when it reaches its peak in 24 hrs
d. This is an accurate indicator of myocardial injury
e. It is only an accurate indicator of skeletal muscle injury
d. This is an accurate indicator of myocardial injury
The nurse is caring for a patient who is receiving an ECG. The nurse notes that leads I, II, and III differ from one another on the cardiac rhythm strip. Why is this?
Select one:
a. The view of the electrical current changes in relation to the lead placement.
b. Electrocardiogram (ECG) equipment has malfunctioned
c. The limb leads are in an incorrect manner
d. The circadian rhythm has changed.
e. Conduction of the heart differs with lead placement.
a. The view of the electrical current changes in relation to the lead placement.
The staff educator is teaching a class on conduction problems in the heart. The educator explains that in an adult patient who has damage to the electrical conduction of the ventricles of the heart, the nurse would expect to see changes in what?
a. QRS complex
b. T wave
c. Y-Z wave
d. P wave
e. U Wave
a. QRS complex
Your patient has returned from the operating room after having a permanent pacemaker implantation. Which potential complication should you assess for in a postoperative patient with permanent pacemaker implantation?
a. Decreased pulse rate
b. Decreased appetite
c. Bleeding at the generator-implantation site
d. Decreased respiratory rate
e. Decreased urine output
c. Bleeding at the generator-implantation site
During a CPR, class a student in the class asks what the difference is between cardioversion and defibrillation. What would be the nurse’s best response?
a. “Defibrillation is synchronised with the electrical activity of the heart, cardioversion is not.”
b. “Cardioversion is done on a beating heart, defibrillation is not.”
c. “The difference is the timing of the delivery of the electric current.”
d. “Cardioversion is always attempted before defibrillation because it is not as dangerous.”
e. They are identical
b. “Cardioversion is done on a beating heart, defibrillation is not.”
The triage nurse in the emergency department assesses a 66-year-old male patient who presents to the emergency department with complaints of midsternal chest pain that has lasted for the last 5 hours. The nurse is aware that because of the length of time the patient has been experiencing symptoms, if they are due to a MI, what has happened to the myocardium?
a. May have developed an increased area of infarction
b. That it couldn’t be an MI, it must be reflux
c. Will probably not have more damage than if he came in immediately
d. Has been damaged already, so immediate treatment is no longer necessary
e. Can have restoration of the area of dead cells with proper treatment
a. May have developed an increased area of infarction
The nurse knows that the blood vessel most commonly used as source for a (coronary artery bypass graft) CABG is what?
a. Greater saphenous vein
b. Femoral artery
c. Femoral vein
d. Brachial vein
e. Brachial artery
a. Greater saphenous vein
A patient with angina is beginning nitroglycerin. Before administering the drug the nurse informs the patient that immediately after administration, the patient may experience what?
a. Drowsiness
b. Throbbing headache or dizzyness
c. Nervousness
d. Paraesthesia
e. Tinnitus
b. Throbbing headache or dizzyness
The nurse is caring for a patient who has experienced an MI. The nurse notes that there are changes in the ECG of the patient. What change on an ECG may indicate that ischaemia is occurring?
a. T-wave inversion
b. Q-wave changes with no change in ST or T wave
c. P-wave enlargement
d. T-wave elevation
e. P-wave inversion
a. T-wave inversion
The nurse caring for a client with acute coronary syndrome knows that the top priority in the care of this patient is what?
a. Balancing intake and output
b. Decreasing energy expenditure of the myocardium
c. Balancing myocardial oxygen supply with demand
d. Decreasing nutritional need of myocardial muscle
e. Making sure they get a good cup of coffee
c. Balancing myocardial oxygen supply with demand
You are caring for a patient who is scheduled to undergo a valvuloplasty to repair a defective heart valve. You would include in your patient education which priority area?
a. Long-term anticoagulant therapy
b. Exercise program
c. Patient controlled analgesia
d. Long-term steroid therapy
e. Long-term antibiotic therapy
a. Long-term anticoagulant therapy
You are caring for an Ethiopian refugee who has been diagnosed with mitral valve regurgitation. You know that in developing countries the most common cause of mitral valve regurgitation is what?
a. Sepsis and its sequelae
b. A decrease in gamma globulins
c. An insect bite
d. Paracetamol overdose
e. Rheumatic heart disease and its sequelae
e. Rheumatic heart disease and its sequelae
The nurse notes that a patient has developed a cough productive for mucoid sputum, is short of breath, has cyanotic hands and has noisy, moist-sounding, rapid breathing. These symptoms indicate:
a. Right ventricular hypertrophy
b. Pericarditis
c. Heart failure
d. Right atrial hypertrophy
e. Pulmonary oedema
e. Pulmonary oedema
You are assessing a patient suspected of having right-sided heart failure. What assessment finding may indicate right-sided heart failure?
a. Pulmonary oedema
b. Distended neck veins
c. Dry cough
d. Hypotension
e. Orthopnoea
b. Distended neck veins
You are caring for an 84-year-old male who has just returned from the operating room (OR) after inguinal hernia repair. You note the patient has fluid volume excess from the OR and is at risk for left-sided heart failure. What signs and symptoms indicate left-sided heart failure?
a. Left upper quadrant pain
b. Bibasilar fine crackles
c. Dependent oedema
d. Jugular vein distention
e. Right upper quadrant pain
b. Bibasilar fine crackles
Bibasilar crackles: are the clicking, rattling, or crackling noises heard on auscultation of the lung caused by the”popping open” of small airways and alveoli collapsed by fluid, exudate, or lack of aeration during expiration.
(Which is a sign of left sided HF)
The cardiac monitor alarm alerts the critical care nurse that the patient is showing no cardiac rhythm on the monitor. When the nurse assesses the patient, she determines that the patient is experiencing cardiac arrest. In providing cardiac resuscitation documentation, how will the nurse describe this initial absence of cardiac rhythm?
a. Pulseless electrical activity (PEA)
b. asystole
c. Atrial fibrillation
d. Ventricular fibrillation
e. Ventricular tachycardia
b. asystole
Intracardia thrombi are especially common in what kind of patients?
a. Those with atrial fibrillation
b. Those with ventricular tachycardia
c. Those with pulmonary oedema
d. Those with ventricular fibrillation
e. Those with atrial tachycardia
a. Those with atrial fibrillation
The nurse is taking a health history on a new patient. The patient reports experiencing pain in the left lower leg and foot when walking. This pain is relieved with rest. The nurse notes that the left lower leg is slightly oedematous and is hairless. What does the nurse suspects that the patient may be experiencing?
a. Coronary artery disease
b. Raynaud’s disease
c. Intermittent claudication
d. Diabetes
e. Arterial embolus
c. Intermittent claudication
Intermittent claudication is muscle pain (ache, cramp, numbness or sense of fatigue) which occurs during exercise, such as walking, and is relieved by a short period of rest.
While assessing a patient the nurse notes that the patient’s ankle-brachial index (ABI) of the right leg is 0.40. The nurse is aware that this may indicate what?
a. Adequate peripheral circulation
b. Dependent oedema
c. Arterial narrowing
d. Inadequate coronary output
e. Venous narrowing
c. Arterial narrowing
You are admitting a 32-year-old woman to your unit. The woman is to undergo major surgery and will be on bed rest for at least 48 hours. While doing the admission assessment the patient tells you she takes oral contraceptives. You know that this puts the patient at an increased risk of developing what?
a. Deep vein thrombosis
b. Intermittent claudication
c. Thoracic aneurysm
d. Pressure areas
e. Raynaud’s disease
a. Deep vein thrombosis
The nurse is caring for a patient who is admitted to your unit with a diagnosis of venous ulceration unresponsive to treatment. What is the nurse most likely to find during an assessment of this patient?
a. Pale wound bed
b. No exudate
c. Deep wound bed
d. Heavy exudate
e. Gangrene
d. Heavy exudate
Graduated compression stockings are used to treat and prevent venous insufficiency, leg ulcers, and varicose veins. What amount of compression would be prescribed for patients with venous stasis ulceration?
a. Over 80 mm Hg
b. 35–45 mm Hg
c. 40–50 mm Hg
d. 20–30 mm Hg
e. 25–35 mm Hg
c. 40–50 mm Hg
A nurse is assessing a new patient who is diagnosed with peripheral arterial disease. The nurse cannot feel the pulse in the patient’s left foot. What could the nurse use to assess the blood flow in the patient’s left foot?
a. Palpation
b. Doppler
c. An ultrasound machine
d. A fetascope
e. A stethoscope
b. Doppler
The steps to obtaining an ABI are:
1. Apply the appropriate size blood pressure cuff to the patient’s ankle above the malleolus.
2. Measure brachial pressures in both arms.
3. Have the patient rest in a supine position for about 5 minutes.
4. Palpate the posterior tibial and dorsalis pedis arteries.
Put the steps of measuring an ABI in the correct order.
a. 3, 1, 4, 2
b. 2, 4, 3, 1
c. 4, 1, 3, 2
d. 1, 2, 3, 4
e. 4, 2, 1, 3
a. 3, 1, 4, 2
The nurse is caring for a client with a leg ulcer caused by arterial insufficiency. The nurse knows that a recommended treatment for arterial insufficiency of the leg is what?
a. Anti thrombolytic medications
b. TED stockings
c. Compression stockings
d. Vascular reconstruction
e. Embolectomy
d. Vascular reconstruction
The nurse is assessing a patient's bladder by percussion. The nurse elicits dullness after voiding. What does this finding indicate? Select one: a. The presence of an alien life-form b. Kidney enlargement c. Incomplete bladder emptying d. Ureteral obstruction e. Dehydration
c. Incomplete bladder emptying
You are a urology nurse caring for a male
patient admitted to your unit with bladder distention from prostatichypertrophy. The physician orders placement of an indwelling urinary catheter.
The nurse and urologist are both unsuccessful in catheterising this patient due
to the prostatic obstruction. What approach does the nurse anticipate the
physician using to drain the patient’s bladder?
a. Scheduling the patient immediately for surgery
to relieve the bladder obstruction
b. Restrict fluids and try again in 6 hours
c. Application of warm compresses to the perineum
to assist with relaxation, which will result in the patient voiding on his own
d. Medication administration to relax the bladder
muscles and attempting catheterisation in 6 hours
e. Insertion of a suprapubic catheter
e. Insertion of a suprapubic catheter
The nurse has implemented a bladder retraining
program in a 65-year-old woman after the removal of an indwelling urinary catheter from this patient. The nurse places the patient on a timed voiding schedule and performs an ultrasonic bladder scan after each void. The nurse notes that the patient has 50 mL of urine remaining in her bladder after voiding. What would be the nurse’s best response to this finding?
a. Place an indwelling urinary catheter
b. Avoid further interventions at this time, as
this is an acceptable finding
c. Plan for insertion of a supra-pubic catheter
d. Press on the patient’s bladder in an attempt to
encourage complete emptying
e. Perform a straight catheterisation on this
patient
b. Avoid further interventions at this time, as
this is an acceptable finding
The nurse is caring for a patient who is not allowed oral intake of fluid or food. When evaluating this patient’s urinalysis, what would the nurse anticipate?
a. A fixed urine specific gravity
b. A fluctuating urine specific gravity
c. None of the above
d. An increased urine specific gravity
e. A decreased urine specific gravity
d. An increased urine specific gravity
A diabetic patient with renal failure has been admitted to your unit. What is the most life-threatening effect of renal failure you will monitor for?
a. Polyuria
b. Accumulation of wastes
c. Depletion of calcium
d. Lack of blood pressure control
e. Retention of potassium
e. Retention of potassium
The nurse is caring for a patient who describes his changes in voiding patterns. The patient states, “I feel the urge to empty my bladder several times an hour and when the urge hits me I have to get to the restroom quickly. But when I empty my bladder, there does not seem to be a great deal of urine flow.” What would the nurse expect this patient’s physical assessment will likely reveal?
a. Renal failure
b. Dehydration
c. Urine retention
d. Hypotension
e. Haematuria
c. Urine retention
What function does the kidney perform to assist
in maintaining acid–base balance within the necessary normal range?
a. Excrete bicarbonate in the urine
b. Excrete acid in the lungs
c. Return bicarbonate to the body’s circulation
d. Return acid to the body’s circulation
e. Excrete alkali from the body’s circulation
c. Return bicarbonate to the body’s circulation
The nurse is caring for a patient receiving haemodialysis treatments. The patient has had surgery to form an arteriovenous fistula. What is most important for the nurse to be aware of when providing care for this patient?
a. The patient shouldn’t feel pain during initiation of dialysis
b. All of the above
c. Taking a blood pressure reading on the affected
arm can cause clotting of the fistula.
d. Using a stethoscope for auscultating the fistula is contraindicated.
e. The patient feels best immediately after the
dialysis treatment.
c. Taking a blood pressure reading on the affected arm can cause clotting of the fistula.
Renal failure can have prerenal, renal, or postrenal
causes. A patient presents with acute renal failure and is being assessed to determine where, physiologically, the cause is. If the cause is found to be prerenal, which condition most likely caused it?
a. Heart failure
b. UTI
c. Glomerulonephritis
d. Aminoglycoside toxicity
e. Ureterolithiasis
a. Heart failure
Pre-renal- ECF volume depletion, Low cardiac output, Low systemic vascular resistance, Increased renal vascular resistance
Renal- Infiltrative diseases, Infections & acute vascular nephropathy
Post-renal- Tubular precipitation, Ureteral obstruction and Bladder obstruction
A patient is receiving patient education prior
to beginning continuous ambulatory peritoneal dialysis. What would the nurse teach the patient that the most common complication associated with this procedure is?
a. Constipation
b. Dehydration
c. Peritonitis
d. Blood loss
e. DVT
c. Peritonitis
The clinic nurse is teaching a young wife about
preventing recurrent urinary tract infections. What information should the nurse include?
a. Wipe back to front after going to the toilet
b. Void every 6 to 8 hours.
c. Drink liberal amounts of fluids.
d. Avoid voiding immediately after sexual intercourse.
e. Bathe daily.
c. Drink liberal amounts of fluids.
You are caring for a patient admitted with a diagnosis of renal failure. When youreview your patient’s laboratory reports, you note that the patient’s magnesium levels are high. What would be important for you to assess?
a. Visual acuity
b. Cool,Clammy skin
c. Increased Serum magnesium
d. Diminished Deep tendon reflexes
e. Tachycardia
d. Diminished Deep tendon reflexes
You are working on a burn unit. One of your patients is exhibiting signs and symptoms of third spacing, which occurs when fluid moves out of the intravascular space but not into the intracellular space. Based upon this fluid shift, what would you expect the patient to demonstrate?
a. Hypertension
b. Hypervolaemia
c. Decreased oxygen saturations
d. Hypovalaemia
e. Bradycardia
b. Hypervolaemia
A patient with anxiety presents to the emergency room. The triage nurse notes
upon assessment that the patient is hyperventilating. The triage nurse is aware
that hyperventilation is the most common cause of which acid-base imbalance?
Select one:
a. Respiratory acidosis
b. None of the above
c. CNS disturbances
d. Respiratory alkalosis
e. Increased PaCO2
d. Respiratory alkalosis