Deck 8: Chest Disorders

Question 1

The nurse practitioner sees a patient in the emergency department with reports of chest pain and nausea.To analyze the patient's condition, what further information is needed?
1)Whether there has been constipation.
2)A description of the pain.
3)Information regarding last food intake.
4)Information regarding urinary difficulties.

Answer 1

2

Question 2

Mr.Thomas comes in for a health examination with his nurse practitioner.When the nurse practitioner measures his blood pressure, the systolic is 150 mm and the diastolic is 80 mm.When Mr.Thomas asks if that is a good pressure for him, the nurse practitioner responds:
1)It is normal for your age.
2)Isolated hypertension is usually identified by a systolic blood pressure (SBP)higher than 160 mm Hg.
3)When evaluating blood pressure, a higher diastolic blood pressure (DBP)is risky.
4)There is a risk of a cardiovascular event for you with an SBP of 150 mm Hg.

Answer 2

2

Question 3

The nurse practitioner implements an approved plan of care proposed in the National Asthma Education and Prevention Program Expert Panel Report-3 (NAEPP-EPR-3)for an older adult patient with asthma.This includes which of the following? Select all that apply.
1)Completion of the assessment and monitoring, as this is not an ongoing process.
2)Patient, family, and professional education so as to create a partnership in asthma management.
3)Control of comorbidities.
4)Monitoring of appropriate use of medications.
5)Use of a standardized asthma care plan.

Answer 3

2, 3, 4

Question 4

John is 80 years old and is experiencing the following: weight gain, tachycardia, neck vein distention, and cognitive impairment.The nurse practitioner assesses for which of the following to support a diagnosis of heart failure? Select all that apply.
1)Laterally displaced point of maximum impulse of apical pulse.
2)Rales in bilateral lower lobes not due to atelectasis or ascites.
3)Functional impairment.
4)Increase in appetite and alertness.
5)Asymptomatic.

Question 5

A patient comes to the health-care provider office for a checkup.The nurse practitioner notes that the patient is 67 years old and is presenting symptoms of dizziness, orthopnea, and edema.The nurse practitioner begins a focused assessment of the:
1)Cardiovascular system.
2)Respiratory system.
3)Neurological system.
4)Reproductive system.

Question 6

The nurse practitioner is preparing discharge instructions for a 79-year-old man with newly diagnosed asthma.Which of the following are important instructions to include? Select all that apply.
1)Infections can lead to an occurrence of asthma.
2)Experiencing strong emotions like anger can trigger an asthma episode.
3)As you get older, you are more likely to experience difficulty breathing.
4)Symptoms of asthma may include a runny nose or postnasal drip.
5)There is no need to follow up with your doctor unless your symptoms get worse.

Question 7

Ms.Jameson, 72 years old, comes to the clinic with concerns about her breathing.She states that she is having trouble with mucus collection and difficulty coughing it out.The nurse practitioner suggests which of the following? Select all that apply.
1)As you get older, the tissue in your lungs is not as flexible to aid in exhaling.
2)The muscles that help to inhale become stronger as you age.
3)The body contains less water as you age, and the mucus begins to dry out.
4)As you get older, there is an increase in the exchange of gases between the lungs and the blood vessels.
5)The cough reflex is normal, but the mucus is too thick.

Question 8

Sam is 64 years old and has been feeling weak, lightheaded, and slightly nauseous.He goes to the urgent care center where the nurse practitioner initiates an assessment.Which of the following suggest an arrhythmia? Select all that apply.
1)Chest x-ray showing an increased size of the left atria.
2)History of alcohol drinking.
3)Lack of family history of any acute heart conditions.
4)No history of heart pounding, racing, or skipping beats.
5)Palpitations and syncope.

Question 9

The nurse practitioner identifies a late cardiac murmur in an older adult patient.A student nurse asks what condition this suggests.The nurse practitioner responds that this kind of murmur is most often due to which of the following? Select all that apply.
1)Weakening valves
2)Papillary muscle dysfunction
3)Mitral annular calcification
4)Heart blockage
5)Mitral stenosis

Question 10

The nurse practitioner is seeing patients in the respiratory clinic.An 85-year-old woman comes in with concerns about having difficulty breathing.When considering asthma, the nurse practitioner asks which of the following questions? Select all that apply.
1)Do you feel out of breath during the day?
2)Do you have a cough, especially at night?
3)Do you feel a tightness in your chest?
4)May I listen for wheezing in your breathing?
5)Do you feel any dyspnea?

Question 11

A 58-year-old man is being seen by his nurse practitioner for a cardiac work-up.His cholesterol is 320 mg/d.The nurse practitioner includes teaching about lowering his cholesterol by discussing blood levels and dietary choices.The nurse practitioner says which of the following?
1)Your cholesterol level is above normal for your age and we need to address how to lower it.
2)We will discuss food choices that will raise your LDL levels.
3)We will discuss food choices that will lower your HDL levels.
4)The effects of high cholesterol levels will not be a factor in cardiac disease after you turn 60 years old.

Question 12

The nurse practitioner and a student are examining the apical pulse of an 82-year-old man.The student perceives that there is an S₄ sound.The nurse practitioner interprets that this is likely:
1)An early ventricular filling.
2)Heart blockage.
3)Mitral regurgitation.
4)Normal, due to the man's age.

Question 13

The nurse practitioner knows that risk factors for coronary artery disease (CAD)include atherosclerosis.The nurse practitioner includes teaching on these factors that can be remediated to help prevent CAD:
1)Low blood pressure.
2)Age.
3)Advanced age and male gender.
4)Cholesterol levels and smoking.

Question 14

Ms.Alma, 69 years old, seeks medical advice because she is having trouble breathing.She is experiencing dyspnea, chronic cough with sputum production, decreased activity tolerance, and wheezing.She states that she had not been near anyone with any upper respiratory infections and wonders why this is happening.The nurse practitioner asks which of the following questions? Select all that apply.
1)Have you ever smoked cigarettes?
2)Have you ever worked in a factory or foundry?
3)How long have you experienced these symptoms?
4)Do you have any past history of respiratory difficulties?
5)Have your symptoms increased as you've gotten older?

Question 15

Mr.Borden is 79 years old and lives with his daughter.The daughter provides excellent care for her father and wants to know which changes in his heart and circulatory system are due to aging and which are due to lifestyle choices.The nurse practitioner replies:
1)The size of the heart increases with age.
2)The left ventricle hypertrophies in response to increasing in age.
3)The activity of the heart decreases in its ability to deal with stress, as well as to provide physical strength as one ages.
4)The patient's diet affects the ability of the heart to balance blood pressure.