Nursing Board Exam Reviewer Part 2 of 5

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161. A classic sign of cardiogenic shock is

a)      Tissue hypoperfusion
Tissue hypoperfusion is manifested as cerebral hypoxia (restlessness, confusion, agitation).

b)      High blood pressure
Low blood pressure is a classic sign of cardiogenic shock.

c)      Hyperactive bowel sounds
Hypoactive bowel sounds are classic signs of cardiogenic shock.

d)      Increased urinary output
Decreased urinary output is a classic sign of cardiogenic shock.

162. Vasoactive drugs which cause the arteries and veins to dilate, thereby shunting much of the intravascular volume to the periphery and causing a reduction in preload and afterload include agents such as

a)      Sodium nitroprusside (Nipride)
Sodium nitroprusside is used in the treatment of cardiogenic shock.

b)      Norepinephrine (Levophed)
Norepinephrine (Levophed) is a vasopressor that is used to promote perfusion to the heart and brain.

c)      Dopamine (Inotropin)
Dopamine (Inotropin) tends to increase the workload of the heart by increasing oxygen demand; thus, it is not administered early in the treatment of cardiogenic shock.

d)      Furosemide (Lasix)
Furosemide (Lasix) is a loop diuretic that reduces intravascular fluid volume.

163. Which of the following terms refers to a muscular, cramp-like pain in the extremities consistently reproduced with the same degree of exercise and relieved by rest?

a)      Intermittent claudication
Intermittent claudication is a sign of peripheral arterial insufficiency.

b)      Aneurysm
An aneurysm is a localized sac of an artery wall formed at a weak point in the vessel.

c)      Bruit
A bruit is the sound produced by turbulent blood flow through an irregular, tortuous, stenotic, or dilated vessel.

d)      Ischemia
Ischemia is a term used to denote deficient blood supply.

164. Which of the following observations regarding ulcer formation on the patient’s lower extremity indicate to the nurse that the ulcer is a result of venous insufficiency?

a)      The border of the ulcer is irregular.
The border of an ulcer caused by arterial insufficiency is circular.

b)      The ulcer is very painful to the patient, even though superficial.
Superficial venous insufficiency ulcers cause minimal pain.

c)      The ulcer base is pale to black.
The base of a venous insufficiency ulcer shows beefy red to yellow fibrinous color.

d)      The ulcer is deep, involving the joint space.
Venous insufficiency ulcers are usually superficial.

165. A diagnostic test that involves injection of a contrast media into the venous system through a dorsal vein in the foot is termed

a)      contrast phlebography.
When a thrombus exists, an x-ray image will disclose an unfilled segment of a vein.

b)      air plethysmography
Air plethysmography quantifies venous reflux and calf muscle pump ejection.

c)      lymphangiography.
In lymphangiography, contrast media are injected into the lymph system.

d)      lymphoscintigraphy.
In lymphoscintigraphy, a radioactive-labeled colloid is injected into the lymph system.

166. The nurse teaches the patient with peripheral vascular disease to refrain from smoking because nicotine causes

a)      vasospasm.
Nicotine causes vasospasm and can thereby dramatically reduce circulation to the extremities.

b)      slowed heart rate.
Nicotine has stimulant effects.

c)      depression of the cough reflex.
Nicotine does not suppress cough. Smoking irritates the bronchial tree, causing coughing.

d)      diuresis.
Nicotine does not cause diuresis.

167. Which of the following types of aneurysms results in bleeding into the layers of the arterial wall?

a)      Dissecting
Dissection results from a rupture in the intimal layer, resulting in bleeding between the intimal and medial layers of the arterial wall.

b)      Saccular
Saccular aneurysms collect blood in the weakened outpouching.

c)      False
In a false aneurysm, the mass is actually a pulsating hematoma.

d)      Anastomotic
An anastomotic aneurysm occurs as a result of infection at arterial suture or graft sites.

168. Which of the following terms refers to enlarged, red, and tender lymph nodes?

a)      Lymphadenitis
Acute lymphadenitis is demonstrated by enlarged, red and tender lymph nodes.

b)      Lymphangitis
Lymphangitis is an acute inflammation of the lymphatic channels.

c)      Lymphedema
Lymphedema is demonstrated by swelling of tissues in the extremities because of an increased quantity of lymph that results from an obstruction of lymphatic vessels.

d)      Elephantiasis
Elephantiasis refers to a condition in which chronic swelling of the extremity recedes only slightly with elevation.

169. Which of the following terms is given to hypertension in which the blood pressure, which is controlled with therapy, becomes uncontrolled (abnormally high) with the discontinuation of therapy?

a)      Rebound
Rebound hypertension may precipitate a hypertensive crisis.

b)      Essential
Essential or primary hypertension denotes high blood pressure from an unidentified source.

c)      Primary
Essential or primary hypertension denotes high blood pressure from an unidentified source.

d)      Secondary
Secondary hypertension denotes high blood pressure from an identified cause, such as renal disease.

170. Officially, hypertension is diagnosed when the patient demonstrates a systolic blood pressure greater than ______ mm Hg and a diastolic blood pressure greater than _____ mm Hg over a sustained period.

a)      140, 90
According to the categories of blood pressure levels established by the JNC VI, stage 1 hypertension is demonstrated by a systolic pressure of 140–159 or a diastolic pressure of 90–99.

b)      130, 80
Pressure of 130 systolic and 80 diastolic falls within the normal range for an adult.

c)      110, 60
Pressure of 110 systolic and 60 diastolic falls within the normal range for an adult.

d)      120, 70
Pressure of 120 systolic and 70 diastolic falls within the normal range for an adult.

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