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2024 NURS 251 FINAL EXAM WITH CORRECT ANSWERS
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2024 NURS 251 FINAL EXAM WITH CORRECT ANSWERS
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2024 NURS 251 FINAL EXAM WITHCORRECT ANSWERS
The nurse is assessing cranial nerve XI (spinal accessory). What would the
nurse ask the patient to do?
-Shrug shoulders
-Close eyes and smell a piece of peppermint candy
-Stick out their tongue
-Walk heel to toe - CORRECT-ANSWERSShrug shoulders
What area of the heart would the nurse listen to for 1 minute before
administering cardiac medications?
-tricuspid area
-erb's point
-mitral area
-aortic area - CORRECT-ANSWERSMitral area
The nurse instructs a student nurse to palpate the patients pulses. What
action would not be part of the cardiovascular assessment?
-palpating both carotid arteries at once to compare rate
-palpating the radial pulses for 1 minute each if irregular
-palpating the dorsalis pedis in the bilateral lower extremities
-palpation bilateral brachial pulses - CORRECT-ANSWERSpalpating both
carotid arteries at once to compare rate
An obese patient with a BMI of 38 states she is unable to exercise do to back
pain and spends most of her day sitting in a chair. The nurse assesses her
lower extremities and notices that the legs are warm but have a brown to
brawny color below the knees to the feet. This is consistent with
-arterial insufficiency
-hypertension
-obesity
-venous insufficiency - CORRECT-ANSWERSVenous insufficiency
A patient has fallen and complains of ankle pain 10 out of 10 and numbness.
When the nurse assesses the ankle there is a bone protruding through the
,skin. The skin is pale and the pulses are not palpable and the patient is
unable to wiggle her toes. He nurse would do what first?
-notify the doctor of the patients assessment findings
-recheck the ankle in 30 minutes
-encourage the patient to ambulate to increase circulation
-have the patient dangle the leg to help relieve the pain by increasing blood
flow to the extremity - CORRECT-ANSWERSNotify the doctor of the patients
assessment findings
A 62 year old male patient complains of pain in his legs when he is walking.
While assessing the patient the nurse notices that the skin on the lower
extremities is shiny with loss of hair, this is consistent with?
-venous insufficiency
-peripheral arterial insufficiency
-hypertension
-obesity - CORRECT-ANSWERSPeripheral arterial insufficiency
A nurse is counseling a patient on risk factors for cardiovascular disease.
Which of these risk factors can be reduced with lifestyle modifications?
Select all that apply
-gender
-hypertension
-family history
-smoking - CORRECT-ANSWERSHypertension, smoking
Decreased or muffled heart sounds may indicate inflammation around the
sac that surrounds and protects the heart is called the
-pericardium
-myocardium
-pleural space
-endocardium - CORRECT-ANSWERSPericardium
During a cardiovascular assessment, the nurse knows that a thrill is
-palpate in the right epigastric area
-vibration that is palpable
-murmur associated with ventricular hypertrophy
-murmur auscultated at the third intercostal space - CORRECT-
ANSWERSVibration that is palpable
What is the best technique to assess an apical pulse?
, -one full minute if irregular on patients skin
-ten seconds then times it by six over patients clothes to prevent
embarrassment
-two full minutes over patients clothes to prevent embarrassment
-fifteen seconds time three on patients skin - CORRECT-ANSWERSOne full
minute if irregular on patients skin
During the assessment of a 20 year old Asian patient the nurse notices that
there is dry, flaky cerumen in the ear canal. What is the significance of this
finding?
-eczema of the ear
-normal findings follow up isn't necessary
-fungal infection that will affect the patients hearing so an ENT consult needs
to be ordered
-represents poor hygiene instruct the patient to clean with an ear cleaner
twice per day - CORRECT-ANSWERSNormal findings follow up isn't necessary
While assessing an 82 year old stroke patient the nurse notices facial
drooping on the left side. The patient is unable to completely close his left
eye. His smile is asymmetrical. The nurse is aware that the patient is at risk
for? Select all that apply
-rhinorrhea
-dysphasia
-epitaxis
-corneal abrasion - CORRECT-ANSWERSDysphasia, corneal abrasion
The nurse has completed a lymph node assessment on a 60 year old female.
The nurse knows that on most heath adults the lymph nodes are?
-greater than 3mm may be tender
-not palpable
-large firm fixed and tender
-rubbery and mobile - CORRECT-ANSWERSNot palpable
What applies when a patient asks about impacted cerumen? Select all that
apply
-indicates that there is an infection
-a common cause of conductive hearing loss
-may be gold or brownish in color
-may have an unusual odor - CORRECT-ANSWERSA common cause of
conductive hearing loss, may be gold or brownish in color
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