Medical Terminology and Concepts, Exams of Nursing

Download Medical Terminology and Concepts and more Exams Nursing in PDF only on Docsity! Advanced Patient Assessment Final Exam Questions With Complete Solutions A 17-year-old man is brought into the emergency department. Vitals are as follows: pulse: 100 BPM, RR: 4 breaths/min, BP: 100/65 mm Hg. The patient was at a party, where he was discovered by his friends to be slumped in a chair and unresponsive. ABG results are: pH: 7.29 PaCO2: 68 mm Hg HCO3: 24 mEq/L BE: -3 mEq/L. The patient's acid-base status is classified as which of the following? A. Uncompensated metabolic acidosis B. Partially compensated respiratory acidosis C. Uncompensated respiratory acidosis D. Compensated respiratory alkalosis Correct Answer C. Uncompensated respiratory acidosis A 32-year-old man comes to the ED after a traffic accident with the following data: pulse: 118 beats/min; RR: 27 breaths/min; BP 100/68 mm Hg; paradoxical chest movement on the left side; breath sounds decreased on the left; and ABG on room air (21%) as follows: pH: 7.32; PaCO2: 70 mm Hg; PaO2: 57 mm Hg; HCO3: 23 mEq/L; BE: 0; SaO2: 86%; CaO2: 15.2 vol%; Hb 13.0; P(A-a)O2: 18 mm Hg. Based on this information, what is the primary cause of the patient's hypoxemia? A. Shunt B. Overall hypoventilation C. V/Q mismatch D. Diffusion defect Correct Answer B. Overall hypoventilation A 35-year-old, 54-kg woman with congestive heart failure enters the ED short of breath. An ABG shows the following results: pH: 7.50 PaCO2: 30 mm Hg HCO3: 23 mEq/L BE: +2 mEq/L The patient's ABG results indicate which of the following? A. Uncompensated respiratory alkalosis B. Compensated respiratory acidosis C. Uncompensated metabolic acidosis D. Uncompensated metabolic alkalosis Correct Answer A. Uncompensated respiratory alkalosis A lateral decubitus view is able to detect as little as __ mL of the pleural fluid? A. 25 to 50 B. 50 to 100 C. 100 to 200 D. 200 to 300 Correct Answer B. 50 to 100 A patient complaining of chest pain that has not been relieved by nitroglycerin should be treated with all of the following except: A. Oxygen therapy B. Stress testing C. Surgical intervention D. Thrombolytic therapy Correct Answer B. Stress testing A patient has the following ABG results: pH: 7.25; PaCO2: 32 mm Hg; HCO3: 16 mEq/L. Based on these findings, the patient has which of the following? A. Compensated metabolic acidosis B. Compensated respiratory acidosis C. Uncompensated respiratory acidosis D. Uncompensated metabolic acidosis Correct Answer D. Uncompensated metabolic acidosis and 4 B. 1 and 2 C. 2, 3, and 4 D. 3 and 4 Correct Answer A. 1, 3, and 4 Before an arterial blood gas (ABG) value is obtained, the patient's clotting parameters should be evaluated because: A. They may affect the accuracy of the sample's pH B. They may affect the patient's PaO2 C. Bleeding time may be prolonged if they are abnormal D. If reduced, they may hinder filling of the syringe with blood during the draw Correct Answer C. Bleeding time may be prolonged if they are abnormal Communication between individuals is affected by which of the following factors? 1. The time of day 2. The cultural heritage 3. The day of the week 4. The level of education A. 1 and 2 B. 1 and 3 C. 2 and 4 D. 3 and 4 Correct Answer C. 2 and 4 Communication between two people can occur only if: 1. The speaker speaks clearly 2. The receiver understands the message 3. Each person understands the medical terminology 4. Both people are in the same room A. 3 and 4 B. 1 and 3 C. 1 and 2 D. 2 and 4 Correct Answer C. 1 and 2 Cough syncope is associated most often with which of the following types of patients? A. Pregnant women B. Middle-aged men with underlying COPD C. Older obese men with diabetes D. Children with asthma Correct Answer B. Middle-aged men with underlying COPD During what type of procedure is the risk of exposure to scatter radiation the greatest? A. Performing or assisting with a bronchoscopy B. Performing or assisting with a chest radiography C. Performing or assisting during fluoroscopy D. Performing or assisting with CT angiography Correct Answer C. Performing or assisting during fluoroscopy Elevation of troponin is associated with what disorder? A. Trauma B. Hepatitis C. Pulmonary embolism D. Acute myocardial infarction Correct Answer D. Acute myocardial infarction Evaluation of blood urea nitrogen (BUN) and creatinine levels in the blood suggests what type of problem? A. Renal failure B. Liver failure C. Gallbladder disease D. Heart disease Correct Answer A. Renal failure For which of the following disorders does a skin test use purified protein derivative (PPD)? A. Histoplasmosis B. Coccidioidomycosis C. Sarcoidosis D. Tuberculosis Correct Answer D. Tuberculosis Given the following ABG results, interpret the acid-base status: pH: 7.44 PaCO2: 25 mm Hg HCO3: 17 mEq/L Base excess: -6 mEq/L A. Uncompensated respiratory acidosis B. Uncompensated metabolic acidosis C. Uncompensated respiratory alkalosis D. Compensated respiratory alkalosis Correct Answer D. Compensated respiratory alkalosis Heavy smokers are prone to what change in the red blood cell count? A. Secondary polycythemia B. Macrocytic anemia C. Hypochromic anemia D. Microcytic anemia Correct Answer A. Secondary polycythemia How much time is represented on the horizontal axis of the ECG paper by five large boxes? A. 3 s B. 5 s In which of the following stages of patient-clinician interaction is the review of physician orders carried out? A. Initial assessment stage B. Introductory stage C. Preinteraction stage D. Treatment stage Correct Answer C. Preinteraction stage In which stage of patient-clinician interaction is the patient identification bracelet checked? A. Introductory stage B. Preinteraction stage C. Treatment stage D. Initial assessment stage Correct Answer A. Introductory stage Injury to the cervical spine roots C3 to C5 is associated with which of the following abnormalities? A. Paralysis of the diaphragm B. Doll's-eye maneuver C. Babinski sign D. Absence of deep tendon reflexes Correct Answer A. Paralysis of the diaphragm On a PA film, what number of posterior ribs visible above the diaphragm indicates a good inspiratory effort? A. 10 B. 6 C. 5 D. 8 Correct Answer A. 10 pH: 7.28; PaCO2: 67 mm Hg; PaO2: 49 mm Hg; SaO2: 76% Hb: 10.1 g/dL; CaO2: 10.4 vol%; HCO3: 26 mEq/L; BE: -2 mEq/L; RR: 25 breaths/min; FiO2: 0.70. Which of the following is true regarding the PaO2? A. It shows mild hypoxemia B. It is adequate C. It shows severe hypoxemia D. It shows moderate hypoxemia Correct Answer D. It shows moderate hypoxemia Radiographic signs of consolidation include which of the following? 1. Lobar distribution 2. Minimal loss of volume 3. Homogenous density late in the process 4. A low shift of the diaphragm A. 2 and 3 B. 2, 3, and 4 C. 1, 2, and 3 D. 1 and 4 Correct Answer C. 1, 2 and 3 Screening information is: A. Obtained by the triage nurse in the emergency department to determine how life-threatening the patient's symptoms are B. Given to the interviewer by the patient at the very beginning of the interview process C. Designed to uncover problem areas that the patient forgot to mention or omitted D. Obtained at health fairs to determine whether the person should see a physician Correct Answer C. Designed to uncover problem areas that the patient forgot to mention or omitted The ability of x-rays to penetrate matter is inversely proportional to which of the following physical properties of matter? A. Density B. Weight C. Diffusion D. Viscosity Correct Answer A. Density The casting of a white shadow on a film is consistent with which of the following situations? A. Less exposed film B. More exposed film C. More penetrated film D. More radiolucent film Correct Answer A. Less exposed film The casting of a white shadow on the film is consistent with which of the following situations? A. More penetrated film B. More exposed film C. More radiolucent film D. Less exposed film Correct Answer D. Less exposed film The normal QRS complex does not exceed what time on the horizontal axis? A. 0.12 s B. 1 s C. 0.05 s D. 0.5 s Correct Answer A. 0.12 s The normal resting respiratory rate in elderly patients is in what range? B. Hepatitis C. Renal failure D. CHF Correct Answer D. CHF What does the QRS complex represent? A. Repolarization of the ventricles B. Depolarization of the atria C. Repolarization of the atria D. Depolarization of the ventricles Correct Answer D. Depolarization of the ventricles What dysrhythmia is characterized by a sawtooth pattern of waves between normal QRS complexes on the ECG tracing? A. Atrial fibrillation B. Atrial flutter C. Ventricular flutter D. Ventricular fibrillation Correct Answer B. Atrial flutter What dysrhythmia often follows sustained ventricular tachycardia? A. Elevated ST segments B. Atrial fibrillation C. Heart block D. Ventricular fibrillation Correct Answer D. Ventricular fibrillation What electrolyte abnormality is associated with irregular pulse, muscle weakness, and abdominal distention? A. Hypokalemia B. Hyponatremia C. Hyperkalemia D. Hypernatremia Correct Answer A. Hypokalemia What instrument is used most widely to quantify neurologic impairment? A. Mini-mental state examination B. APACH C. Merck gait evaluation D. Glasgow coma scale Correct Answer D. Glasgow coma scale What is a decrease in tissue oxygenation called? A. Acidosis B. Hypoxia C. Hypoxemia D. Hypercapnia Correct Answer B. Hypoxia What is an important reason to monitor the heart rate in patients with lung disease? A. A heart rate above or below the normal range is dangerous B. As the heart rate increases, the tissue's demand for oxygen decreases C. Tachycardia is a common finding when hypoxemia is present D. The more efficiently the heart is pumping, the lower is the resting pulse rate Correct Answer C. Tachycardia is a common finding when hypoxemia is present What is considered to be the normal position of the axis in a healthy person's heart? A. 120 to 180 degrees B. 0 to -90 degrees C. 60 to 120 degrees D. 0 to 90 degrees Correct Answer D. 0 to 90 degrees What is often the first clinical sign that suggests the presence of hypoxemia? A. Confusion B. Hypotension C. Exertional dyspnea D. Decreased level of consciousness Correct Answer C. Exertional dyspnea What is represented by the P wave on the ECG tracing? A. Depolarization of the ventricles B. Repolarization of the atria C. Repolarization of the ventricles D. Depolarization of the atria Correct Answer D. Depolarization of the atria What is the appropriate distance for the personal space? A. 6 to 15 feet B. 4 to 12 feet C. 18 inches to 4 feet D. 0 to 18 inches Correct Answer C. 18 inches to 4 feet What is the appropriate distance for the social space from the patient? A. 8 to 20 feet B. 3 to 5 feet C. 4 to 12 feet D. 6 to 18 feet Correct Answer C. 4 to 12 feet C. 7.45 to 7.50 D. Greater than 7.50 Correct Answer B. 7.35 to 7.45 What is the normal value for CaO2: A. 12-16 vol% B. 8-12 vol% C. 4-8 vol% D. 16-20 vol% Correct Answer D. 16-20 vol% What is the normal value of PaO2 in the adult patient? A. 60 - 70 mm Hg B. 50 - 60 mm Hg C. 80 - 100 mm Hg D. 70 - 80 mm Hg Correct Answer C. 80 - 100 mm Hg What is the relative percentage of normal circulating eosinophils? A. 1% to 3% B. 0% to 5% C. 10% to 15% D. 5% to 10% Correct Answer A. 1% to 3% What is the typical lifespan of a red blood cell? A. 120 days B. 30 days C. 60 days D. None of the above Correct Answer A. 120 days What is the ventricular heart rate when the AV node paces the heart? A. 40-60 BPM B. 80-100 BPM C. 40-60 BPM D. 20-40 BPM Correct Answer B. 40-60 BPM What percentage of adults older than 65 years have elevated systolic or diastolic pressure? A. 60% B. 40% C. 20% D. 30% Correct Answer A. 60% What percentage of circulating white blood cells is made up of neutrophils? A. 10% to 30% B. 40% to 75% C. 25% to 50% D. 60% to 85% Correct Answer B. 40% to 75% What percentage of patients over the age of 70 years old in the US have hearing impairment? A. 15% B. 7% C. 60% D. 25% Correct Answer C. 60% What problem is associated with cyanosis of the oral mucosa? A. Reduced arterial oxygenation B. Low cardiac output C. Hyperventilation D. Hypoventilation Correct Answer A. Reduced arterial oxygenation What problem is associated with nasal flaring? A. Increased lung compliance B. Increased dead space ventilation C. Hypoxemia D. Increased work of breathing Correct Answer D. Increased work of breathing What problem is indicated by elevation of the ST segment? A. Myocardial ischemia B. Depletion of serum potassium C. Heart block D. Elevation of serum potassium Correct Answer A. Myocardial ischemia What procedure is performed by a pulmonologist to obtain organisms that may be present deep in the lung in patients with pneumonia? A. Bronchoalveolar lavage (BAL) B. Tracheal intubation with lavage C. Sputum induction with hypotonic nebulized solution D. None of the above Correct Answer A. Bronchoalveolar lavage (BAL) What should be done just before the patient's bracelet is checked? A. Check the patient's SpO2 B. Check the chart for vital signs C. Ask the patient for permission D. Listen to breath sounds Correct Answer C. Ask the patient for permission When vital signs are compared with other signs and symptoms to arrive at a conclusion about what is wrong with a patient, this is known as the: A. Differential diagnosis B. Objective assessment information C. Review of systems D. General clinical presentation Correct Answer A. Differential diagnosis Where does the normal electrical impulse originate for each heartbeat? A. Right bundle branch B. AV node C. Bundle of His D. SA node Correct Answer D. SA node Which chamber is responsible for pumping blood into the pulmonary circulation? A. Right ventricle B. Left atrium C. Left ventricle D. Right atrium Correct Answer A. Right ventricle Which chamber normally has the largest muscle mass? A. Right ventricle B. Left ventricle C. Right atrium D. Left atrium Correct Answer B. Left ventricle Which chamber of the heart initially receives deoxygenated blood from the venae cavae? A. Right atrium B. Right ventricle C. Left ventricle D. Left atrium Correct Answer A. Right atrium Which Glasgow coma scale score is typically an indication for endotracheal intubation? A. <14 B. <10 C. <12 D. <8 Correct Answer D. <8 Which heart chamber typically thickens with aging? A. All four chambers B. The right ventricle C. The left atrium D. The left ventricle Correct Answer D. The left ventricle Which of the following activities are parts of the role of respiratory therapists (RTs) in patient assessment? 1. Assist the physician with diagnostic reasoning skills 2. Help the physician select appropriate pulmonary function tests 3. Interpret arterial blood gas values and suggest mechanical ventilation changes 4. Document the patient diagnosis and the H&P in the patient's chart A. 2 and 3 B. 1, 2, and 3 C. 1 and 4 D. 1, 3, and 4 Correct Answer B. 1, 2, and 3 Which of the following are associated with dilated and unresponsive pupils? 1. Sodium chloride 2. Atropine 3. Brain death 4. Methamphetamines Correct Answer B. 2, 3, and 4 Which of the following are associated with the onset of dysrhythmias? I. Hypoxia II. Electrolyte imbalances III. Sympathetic stimulation IV. Pulmonary hypertension A. I, II, III B. II, IV C. III, IV D. I, II Correct Answer A. I, II, III Which of the following are classified as classical vital signs? 1. Pulse 2. Sensorium 3. Blood pressure 4. Respiratory rate A. 2 and 3 B. 1 and 4 C. 1, 2, and 4 D. 1, 3, and 4 Correct Answer D. 1, 3, and 4 Which of the following are common causes of tachycardia? I. Pain Which of the following best describes the manner in which a clinician should address the older adult patient? A. Use the patient's first name to promote an atmosphere of equality B. Avoid physical contact with the elderly C. Approach the patient in a matter-of-fact, business-like manner D. Address the patient by his or her last name with the appropriate title Correct Answer D. Address the patient by his or her last name with the appropriate title Which of the following clinical conditions most commonly causes a chronic cough? A. Postnasal drip B. Upper airway infection C. Viral infection D. Bronchopulmonary disease Correct Answer A. Postnasal drip Which of the following clinical or chest x-ray findings is consistent with hyperinflation caused by obstructive lung disease? A. Prolonged inspiratory phase B. Large retrosternal space C. Decreased functional residual capacity (FRC) D. Decreased resonance to percussion Correct Answer B. Large retrosternal space Which of the following conditions causes hypothermia? A. Excessive shivering and vasoconstriction B. Invasion of the body by microorganisms that produce an infection C. Damage to the hypothalamus D. Exposure to high environmental temperatures Correct Answer C. Damage to the hypothalamus Which of the following conditions is associated with a characteristic "hacking" cough? A. Smoking B. Viral infection C. Pleural effusion D. Lung cancer Correct Answer Smoking and viral infection Which of the following conditions is often associated with right heart failure? A. Shallow breathing B. Organomegaly C. Hepatomegaly D. Loud A2 heart sound Correct Answer C. Hepatomegaly Which of the following could cause metabolic acidosis? A. Cardiovascular disease B. Renal disease C. Vomiting D. Hypokalemia Correct Answer B. Renal disease Which of the following diseases is characterized by abnormal deep tendon reflexes due to abnormalities of the neuromuscular junction? A. Multiple sclerosis B. Cerebritis C. Syphilis D. Myasthenia gravis Correct Answer D. Myasthenia gravis Which of the following diseases may be suggested by the involvement of multiple nerve roots? A. Seizures B. Brain tumor C. Guillain-Barre syndrome D. Intracranial hypertension Correct Answer C. Guillain-Barre syndrome Which of the following disorders is associated with hyperglycemia? A. Myocardial infarction B. Renal failure C. Hepatitis D. Diabetes Correct Answer D. Diabetes Which of the following disorders would be characterized by Cheyne-Stokes breathing? A. Asthma B. CHF C. Raynaud phenomenon D. COPD Correct Answer B. CHF Which of the following dysrhythmias is associated with lowest cardiac output? A. AV block B. Atrial fibrillation C. Ventricular flutter Which of the following is most likely to cause tracheal deviation? A. Right upper lobe pneumothorax B. Left upper lobe pneumothorax C. Right lower lobe pleural effusion D. Left lower lobe pleural effusion Correct Answer A. Right upper lobe pneumothorax Which of the following is the method of choice for measuring temperature in neonates? A. Oral B. Axillary C. Tympanic D. Rectal Correct Answer B. Axillary Which of the following is the most common cause of a nerve root pathologic condition due to compression? A. Herniated vertebral disc B. Spinal cord injury C. Spinal tumor D. Infection Correct Answer A. Herniated vertebral disc Which of the following is the most common cause of jugular venous distention? A. Auto-positive end-expiratory pressure (auto-PEEP) B. Pneumothorax C. Pneumonia D. Right heart failure Correct Answer D. Right heart failure Which of the following mechanisms does explain why patients with chronic obstructive pulmonary disease (COPD) may have a poor cough? 1. Weak muscles of breathing 2. Increased elastic recoil 3. Airway obstruction 4. Decreased lung compliance A. 1 and 3 B. 2 and 4 C. 2 and 3 D. 1 and 4 Correct Answer A. 1 and 3 Which of the following organisms is responsible for most cases of bacterial pneumonia? A. Pseudomonas B. Klebsiella pneumoniae C. Staphylococcus aureus D. Streptococcus pneumoniae Correct Answer D. Streptococcus pneumoniae Which of the following physical examination findings is associated with myasthenia gravis? A. Mydriasis B. Hepatomegaly C. Miosis D. Ptosis Correct Answer D. Ptosis Which of the following physiological effects is associated with myocardial infarction? A. Increased cardiac output B. Arterial hypertension C. Good blood flow to the brain D. Backup of blood into the lungs Correct Answer D. Backup of blood into the lungs Which of the following radiologic findings are consistent with lobar atelectasis? 1. Collapse of lung tissue 2. Shift in hilar structures toward the area of atelectasis 3. Hemidiaphragm elevation 4. Shift in hilar structures away from the area of atelectasis A. 1 and 4 B. 2 and 3 C. 1, 2, and 3 D. 2, 3, and 4 Correct Answer C. 1, 2, and 3 Which of the following radiologic terms confirm the presence of intrapulmonary disease? A. Compression atelectasis B. Platelike atelectasis C. Air bronchogram D. Sulcus sign Correct Answer C. Air bronchogram Which of the following sequences of events best describes the cough mechanism? A. Inspiration, forceful opening of glottis, contraction of diaphragm B. Inspiration, closure of glottis, forceful opening of glottis C. Opening of glottis, relaxation of diaphragm, closure of glottis D. Opening of glottis, contraction of diaphragm, explosive release of trapped intrathoracic air Correct Answer B. Inspiration, closure of glottis, forceful opening of glottis Which of the following shifts the oxyhemoglobin dissociation curve to the left? A. Increased PaCO2 C. Orthopnea D. Fever Correct Answer D. Fever Which of the following terms describes an abnormal decrease in red blood cell count? A. Anemia B. Polycythemia C. Leukopenia D. Cytothemia Correct Answer A. Anemia Which of the following terms describes an abnormal increase in the proportion of circulating immature neutrophils? A. Leukocytosis B. Neutrophilia C. Leukopenia D. Left shift Correct Answer D. Left shift Which of the following terms describes red blood cells that are larger than normal? A. Macrocytic B. Hyperchromic C. Hypercytotic D. None of the above Correct Answer A. Macrocytic Which of the following terms describes the immature neutrophil? A. Reticuolocyte B. Band C. Erythrocyte D. Monocyte Correct Answer B. Band Which of the following terms is used for blood platelets? A. Erythrocytes B. Hemocytes C. Thrombocytes D. Leukocytes Correct Answer C. Thrombocytes Which of the following terms is used for red blood cells? A. Leukocytes B. Hemocytes C. Monocytes D. Erythrocytes Correct Answer D. Erythrocytes Which of the following terms is used for white blood cells? A. Leukocytes B. Hemocytes C. Erythrocytes D. Thrombocytes Correct Answer A. Leukocytes Which of the following terms is used to describe an abnormally low potassium level? A. Hyponatremia B. Hypocalcemia C. Hypokalemia D. Hypochloremia Correct Answer C. Hypokalemia Which of the following tissues represent the four distinct densities recognized in the x-ray (from higher to lower density)? A. Fat, bone, water, air B. Air, fat, water, bone C. Bone, water, air, fat D. Bone, water, fat, air Correct Answer D. Bone, water, fat, air Which of the following tissues will look radiolucent on the chest radiograph? A. Lungs B. Bone C. Blood D. Liver Correct Answer A. Lungs Which of the following types of leukocytosis is typically seen in patients with viral infection? A. Monocytosis B. Neutrophilia C. Basophilia D. Lymphocytosis Correct Answer D. Lymphocytosis Which of the following types of white blood cells exists as two types-- the B cell and T cell? A. Neutrophil B. Lymphocyte C. Basophil D. Monocyte Correct Answer B. Lymphocyte Which of the following types of white blood cells fights bacterial infection? A. Basophil B. Lymphocyte C. Monocyte D. Neutrophil Correct Answer D. Neutrophil Which of the following types of white blood cells increase with allergic reactions and parasitic infestations? D. CaO2 Correct Answer D. CaO2 Which of the following would describe the ECG of a patient with atrial fibrillation? A. Large bizarre QRS complexes B. No identifiable QRS complexes C. Chaotic baseline between QRS complexes D. Regular ventricular response Correct Answer C. Chaotic baseline between QRS complexes Which of the following would suggest that a patient has congestive heart failure (CHF)? A. Increased retrosternal air space on a lateral film B. Low and flat diaphragm C. Increased cardiothoracic ratio D. Tracheal deviation Correct Answer C. Increased cardiothoracic ratio Why is an ECG tracing so useful? A. It can aid in the diagnosis of cardiac tissue ischemia B. It reflects the heart's pumping ability C. It can identify structural abnormalities in the heart D. It can be used to diagnose malfunctioning valves Correct Answer A. It can aid in the diagnosis of cardiac tissue ischemia Why is it important for an RT to be able to identify cardiac dysrhythmias? A. The RT is primarily responsible for management of the dysrhythmia B. The RT must be able to confirm the physician's initial diagnosis C. It is likely that the RT will observe onset of the initial event D. RT;s are always the first responders for complaints of a cardiac nature Correct Answer C. It is likely the RT will observe onset of the initial event Why is the electrical signal delayed slightly at the AV node? 1. To allow better filling of the ventricles 2. To protect the ventricles against excessively rapid atrial rates 3. To provide time for atrial contraction prior to ventricular systole 4. To prevent premature atrial beats from reaching the ventricles A. 2 and 4 B. 1 and 3 C. 2, 3, and 4 D. 1 and 2 Correct Answer D. 1 and 2