Chapter 029 Review Questions PDF

REVIEW QUESTIONS 1. A 52-year-old woman is admitted with pneumonia, dyspnea, and discomfort in her left chest when taking deep breaths. She has smoked for 35 years and recently lost over 4.5 kg (10 lb). She is started on intravenous antibiotics, high-protein shakes, and 2 L O2 via nasal cannula. Her...

REVIEW QUESTIONS 1. A 52-year-old woman is admitted with pneumonia, dyspnea, and discomfort in her left chest when taking deep breaths. She has smoked for 35 years and recently lost over 4.5 kg (10 lb). She is started on intravenous antibiotics, high-protein shakes, and 2 L O2 via nasal cannula. Her vital signs at the start of treatment are HR 112, BP 138/82, RR 22, tympanic temperature 37.9°C (100.2°F), and oxygen saturation 94%. Which of the vital signs taken 4 hours later reflect a positive outcome of the treatment interventions? (Select all that apply.) 1. Temperature: 37°C (98.6°F) 2. Radial pulse: 98 3. Respiratory rate: 18 4. Oxygen saturation: 96% 5. Blood pressure: 134/78 2. The licensed practical nurse (LPN) provides you with the shift handoff vital signs on four of your patients. Based on your knowledge of the pathophysiology of each patient’s illness, use clinical judgment to prioritize, in order, the follow-up patient assessments to be made. 1. 84-year-old man recently admitted with pneumonia, RR 28, SpO2 85% 2. 54-year-old woman admitted after surgery for repair of a fractured arm, BP 160/86 mm Hg, HR 72 3. 63-year-old man with venous ulcers from diabetes, temperature 37.3°C (99.1°F), HR 84 4. 77-year-old woman with left mastectomy 36 hours ago, temperature 38.3°C (101°F), pulse 110, RR 22, BP 148/62 3. A patient has been hospitalized for the past 48 hours with a fever of unknown origin. His medical record indicates tympanic temperatures of 38.7°C (101.6°F) at 0400, 36.6°C (97.9°F) at 0800, 36.9°C (98.4°F) at 1200, 37.6°C (99.6°F) at 1600, and 38.3°C (100.9°F) at 2000. How would the nurse describe this pattern of temperature measurements? 1. Usual range of circadian rhythm measurements 2. Sustained fever pattern 3. Intermittent fever pattern 4. Resolving fever pattern 4. A patient presents in the clinic with dizziness and fatigue. The assistive personnel (AP) reports a slow but regular radial pulse of 44. Place the following care activities in priority order. 1. Have AP obtain a blood pressure. 2. Request that the patient lie on the clinical stretcher. 3. Assess the patient’s apical pulse for a full minute. 4. Prepare to administer cardiac-stimulating medications as ordered. 5. Obtain oxygen saturation (SpO2). 5. Which of the following patients are at most risk for tachypnea? (Select all that apply.) 1. Patient just admitted with four rib fractures 2. Woman who is 9 months pregnant 3. A patient admitted with hypothermia 4. Postoperative patient waking from general anesthesia 5. Three-pack–per-day smoker with pneumonia 6. Which number marks the location where the nurse would auscultate the point of maximal impulse (PMI)? 1. 1 2. 2 3. 3 4. 4 5. 5 6. 6 1 2 3 4 5 6 7. During admission of an obese patient with heart failure the assistive personnel (AP) reports to the nurse that the blood pressure (BP) is 140/76 on the left arm and 128/72 on the right arm. What actions do you take on the basis of this information? (Select all that apply.) 1. Notify the health care provider immediately. 2. Repeat the measurements on both arms using a stethoscope. 3. Ask the patient whether she has taken her blood pressure medications recently. 4. Obtain blood pressure measurements on lower extremities. 5. Review the patient’s record for her baseline vital signs. 8. The assistive personnel (AP) informs the nurse that the electronic blood pressure machine on the patient who has recently returned from surgery after removal of her gallbladder is flashing a blood pressure of 65/46 and alarming. Place the care activities in priority order. 1. Press the start button of the electronic blood pressure machine to obtain a new reading. 2. Obtain a manual blood pressure with a stethoscope. 3. Check the patient’s pulse distal to the blood pressure cuff. 4. Assess the patient’s mental status. 5. Remind the patient not to bend her arm with the blood pressure cuff. 9. A healthy adult patient tells the nurse that he obtained his blood pressure in “one of those quick machines in the mall” and was alarmed that it was 152/72. He immediately repeated the measurement, and the value was 158/80. His normal BP value ranges from 114/72 to 118/78. The nurse obtains a blood pressure of 116/76. What would account for the blood pressure of 152/72? (Select all that apply.) 1. Cuff too small on the device 2. Arm positioned above heart level 3. Slow inflation of the cuff by the machine 4. Patient did not remove his long-sleeved shirt 5. Insufficient time between measurements 10. A patient with heart failure is one-day postoperative for major abdominal surgery. When the nurse and the assistive personnel raise the head of the bed to sit the patient on the side of the bed before ambulation, the patient immediately complains of dizziness and nausea. What are your immediate actions? (Select all that apply.) 1. Lower the head of the bed and return the patient to the supine position. 2. Obtain vital signs. Copyright © 2023 Elsevier Inc. All rights reserved. Answers: 1.1, 2, 3, 4; 2.1, 4, 2, 3; 3. 3; 4. 2, 1, 3, 5, 4; 5. 1, 2, 5; 6. 5; 7. 2, 5; 8. 4, 1, 3, 2, 5; 9. 1, 4, 5; 10. 1, 2, 4, 5. 3. Encourage the patient to try to sit on the side of the bed and then stand. 4. Allow the patient to rest for 20 to 30 minutes. 5. Raise the head of the bed again and obtain blood pressure readings. Rationales for Review Questions can be found on the Evolve website. Copyright © 2023 Elsevier Inc. All rights reserved.