NSG-316 EXAM 3 NEWEST STUDYGUIDE ACTUAL EXAM 2025 QUESTIONS AND CORRECT DETAILED ANSWERS, Exams of Nursing

Download NSG-316 EXAM 3 NEWEST STUDYGUIDE ACTUAL EXAM 2025 QUESTIONS AND CORRECT DETAILED ANSWERS and more Exams Nursing in PDF only on Docsity! NSG-316 EXAM 3 NEWEST STUDYGUIDE ACTUAL EXAM 2024-2025 QUESTIONS AND CORRECT DETAILED ANSWERS when you inspect the chest of an aging adult, what do you look for? Correct Answer the shape and configuration When someone complains of SOB when laying down, what do you ask them? Correct Answer how many pillows do they sleep on When someone has chronic COPD, what would you expect their chest to look like? Correct Answer Barrel chested What are differences between the right and left lungs? Correct Answer Left lung = 2 lobes, is narrower than the right because heart bulges to the left right lung = 3 lobes, but shorter than In a normal healthy adult, the lung assessment finding would be Correct Answer vesicular breath sounds and you will hear them over the peripheral fields of the lungs What is the bell of the stethoscope designed to hear? Correct Answer lower pitched sounds What sound can be generated from the larynx? Correct Answer vocal sounds When doing assessment of breathe sounds, what pattern do you listen in? Correct Answer you go from side to side When assess adults, how do you hold the diaphragm of the stethoscope? Correct Answer hold the diaphragm firmly to the chest, especially on males because of hair decreased or absent breath sounds can be caused by what? Correct Answer any bronchial obstruction (ex. pneumonia) Any obstruction (Partial, or if a lung collapsed) can cause what? Correct Answer unequal breaths What are adventitious sounds? Correct Answer abnormal sounds that can be heard in the lungs when you auscultate With aging adults, what happens to the respiratory system? Correct Answer Costal cartilages become calcified = less mobile thorax lungs have a more rigid structure = lungs are harder to inflate have decreased # of alveoli = less surface area lung bases are less ventilated = because of the result of closing off a # of airways what are the breathe sounds which are moderately pitched and heard over bronchi Correct Answer Bronchovesicular Bronchial Vesicular What are ronchii? Correct Answer low-pitched wheezing sounds What does the use of accessory muscles indicate? Correct Answer indicates the present of a disorder that affects a person's ability to breathe What is a bruit? Correct Answer low-pitched blowing sounds usually heard during systole a blowing, swishing sound which indicates blood flow turbulence What is a thrill? Correct Answer a palpable vibratory sensation that can be felt with your hand and is frequently felt in the heart valve areas of auscultation Where do you find the apical pulse? Correct Answer 5th left intercostal space at the mid clavicular line How do you document rhythm? Correct Answer strong, regular, irregular, weak etc. how does crepitus sound? Correct Answer grating, crackling or popping sounds (rice crispies) how do you document edema? Correct Answer 1+ 2+ 3+ 4+ where are you going to palpate the dorsalis pedis pulse? Correct Answer on the top of the foot If you are unable to palpate the dorsalis pedis pulse, what would you use to be able to hear it? Correct Answer a doppler ultrasonic probe if you have a patient complaining of edema on the left arm which experts to the shoulder and patient has they had heart surgery, what would you suspect? Correct Answer you would suspect lymph drainage is blocked or obstructed what are modifiable risk factors in terms of cardiovascular disease? Correct Answer things that we can change such as lifestyle choices What are non-modifiable risk factors in terms of cardiovascular disease? Correct Answer factors that we can't change such as race, age, ethnicity, socioeconomic status, educational level, gender Where do you palpate for a tibial pulse? Correct Answer between the medial malleolus and achilles tendon Chronic venous insufficiency = Correct Answer brown pigment What are crackles (rales)? Correct Answer discontinuous popping sounds heard over inspiration What are wheezes? Correct Answer continuous musical sounds heard mainly over expiration What are discontinuous sounds? Correct Answer adventitious sounds which last 2 seconds or less. they come in series and then stop Which adventitious sounds are discontinuous sounds? Correct Answer fine/coarse crackles Atelectatic crackles pleural friction rub What are continuous sounds? Correct Answer adventitious sounds that last longer than 2 seconds which adventitious sounds are continuous sounds? Correct Answer sibilant and sonorous rhonchi wheeze stridor 1+ edema Correct Answer mild putting, slight indentation, no perceptible swelling 2+ edema Correct Answer moderate pitting, indentation subsides rapidly 3+ edema Correct Answer deep pitting, indentation remains, leg looks swollen 4+ edema Correct Answer very deep pitting, indentation lasts a long time, leg very swollen S3 occurs when? Correct Answer immediately after S2 is caused by cardiac pathology ventricular filling which creates vibrations that can be heard over the chest S4 occurs when? Correct Answer just before S1 Orthopnea Correct Answer how many pillows are used when sleeping or laying down in order to be able breathe Where can the aortic valve be auscultated? Correct Answer 2nd right interspace Where can the pulmonic valve be ausculated? Correct Answer 2nd left interspace where can the tricuspid valve be auscultated? Correct Answer left 4th intercostal space/lower sternal border - pulmonic (right side) and aortic (left side) - open during systole to allow blood to be ejected from the heart cardiac output (CO) = Correct Answer SV (stroke volume) * heart rate (HR) S1 Correct Answer occurs with the closure of AV valves beginning of systole loudest at the apex S2 Correct Answer occurs with the closure of SL valves end of systole is loudest at the base S3 Correct Answer it occurs when the ventricles are resistant to filling during the early rapid phase; it occurs immediately after S2, when the AV valves open and atrial blood first pours into the ventricles - associated with heart failure S4 Correct Answer end of diastole (presystolic), when the ventricle is resistant to filling atria push blood into noncompliant ventricle, creates vibrations murmur Correct Answer blowing sound that can be low, medium, or high pitched in the chest wall velocity of blood increases but viscosity of blood decreases can occur in exercise, thyrotoxicosis structural defects in the valves or unusual openings occur in the chamber use bell of stethoscope bruit Correct Answer vascular murmur blowing, swishing sound indicating turbulent blood flow heart failure Correct Answer inability to pump enough blood to the body and the circulation becomes backed up and congested falling O2 sats, weak pulse, cool/moist skin, dilated pupils, pale/gray skin, N/V, decreased BP, high RR orthopnea Correct Answer difficulty breathing in supine position fatigue, weakness, dizziness, dyspnea orthostatic hypotension Correct Answer sudden drop in BP (by 20 or more) when rising or sitting. HR may increase by 20 or more beats/minute caused by abrupt peripheral vasodilation without a compensatory increase in cardiac output dizziness, fatigue, risk of falling, passing out syncope Correct Answer fainting (temporary loss of consciousness) may reflect serious underlying structural heart disease decrease in BP, lightheadedness, dizziness, confusion atherosclerosis Correct Answer deposition of fatty plaques on the intima of the arteries arteriosclerosis Correct Answer peripheral blood vessels grow more rigid with age; possible Ca build up causes rise in systolic BP chest pain Correct Answer CV (ischemic) CV (non-ischemic) pulmonary gastrointestinal dermatologic musculoskeletal/neurological psychogenic venous blood flow Correct Answer 1. skeletal muscles milk the blood proximally, back towards the heart 2. pressure gradient caused by breathing. inspiration makes the thoracic pressure decrease and abdominal pressure increase 3. the intraluminal valves ensure unidirectional flow right lymphatic duct Correct Answer empties into the right subclavian vein drains right side of the head, neck, arm, thorax, right lung and pleura, right side of heart, right upper section of the liver thoracic duct Correct Answer drains the rest of the body empties into the left subclavian vein deep vein thrombosis Correct Answer blood clot formation in vein causes unilateral edema lymphedema Correct Answer swelling of the extremity due to obstructed lymph channel is it normal for BP to be increases in older adults? why? Correct Answer yes because the arteries over time and due to lifestyle will thicken and stiffen, resulting in an increased systolic BP modifiable CV disease risk factors Correct Answer abnormal lipids smoking hypertension diabetes abdominal obesity psychosocial factors poor fruit/veggie intake alcohol use lack of regular exercise can cause hypoxemia S/S: tachycardia, increased RR, and could hear crackles asthma Correct Answer hypersensitivity to certain allergens, stress, or exercise can produce a bronchospasm, inflammation, edema, and secretion of mucus into the airways prolonged expiration with bilateral wheezing could also hear rhonchi if excess mucus production is occurring emphysema Correct Answer permanent enlargement of air sacs increase in airway resistance, especially on expiration causes decreased chest expansion dec breath sounds, tachypnea, may have muffled heart sounds due to over-distention of lungs pneumothorax Correct Answer free air in pleural space (pleural effusion) that causes partial/complete lung collapse usually unilateral unequal chest expansion, tachypnea, cyanosis possibly treat with a chest tube hemothorax Correct Answer blood in the pleural space (pleural effusion) possible treat with chest tube atelectasis Correct Answer collapsed and shrunken alveoli as a result of airway obstruction increased RR, pulse, possible cyanosis chest expansion is decreased on affected side will have decreased vesicular sounds concerned about this with post-op patients discontinuous sounds Correct Answer - crackles (fine and coarse) - atelectatic crackles - pleural friction rub continuous sounds Correct Answer - wheeze (sibilant and sonorous rhonchi) - stridor stridor is a high pitched, inspiratory wheezing sound associated with... Correct Answer upper airway obstruction the most appropriate position for the patient to assume when auscultating for extra heart sounds or murmurs is... Correct Answer roll toward the left side claudication is caused by Correct Answer arterial insufficiency older males have... Correct Answer decreased pedal pulses LDL level Correct Answer 130 mg/dL (should be under 100) what position is indicative of COPD? Correct Answer tripod position Stimulus to breathe Correct Answer An increase of carbon dioxide in the blood (hypercapnia) stridor Correct Answer High pitched, inspiratory, louder in neck, croup and acute epiglottis modified allen test Correct Answer evaluates adequacy of collateral circulation occlude both ulnar and radial arteries let go of ulnar first and let go of radial once blood flow is returning (hand becomes less pale) sluggish return suggest occlusion of collateral arterial flow