NR 603 Week 4 APEA Predictor Exam study
Guide Questions With Correct Detailed
Answers & Rationales
1. During pregnancy, dyspnea accompanied by increased respiratory rate, cough, t t t t t t t t
t rales, or respiratory distress raises concerns of:
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peripartum cardiomyopathy t
Explanation:
Dyspnea accompanied by increased respiratory rate, cough, rales, or respiratory distress raises
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concerns of possible infection, asthma, pulmonary embolus, or peripartum cardiomyopathy.
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2. The middle section of the thoracic cavity containing the esophagus, trachea, heart,
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and great vessels is the:
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mediastinum
Explanation:
The middle section of the thoracic cavity containing the esophagus, trachea, heart, and great
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vessels is the mediastinum. The right and left pleural cavities, are on either side of the
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mediastinum and those contain the lungs. The visceral pleura encloses the lung. The
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pericardium surrounds the heart.
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3. A patient is unable to identify the smell of an orange. This inability could reflect an
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abnormality in cranial nerves:
t t t t
Explanation:
Cranial Nerve I is the olfactory nerve responsible for the sense of smell. To test the sense of smell,
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the examiner presents the patient with familiar and nonirritating odors. A person should normally
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perceive odor on each side and correctly identify the source. Cranial Nerves Il and Ill assess vision
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and pupillary reaction. Cranial Nerve VIII tests the hearing and balance.
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4. A transient ischemic attack is: t t t t
a transient episode of neurologic dysfunction by focal brain, spinal cord, or retinal ischemia,
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without acute infarction t
Explanation:
TIA is now defined as "a transient episode of neurological dysfunction caused by focal brain, spinal
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cord, or retinal ischemia, without acute infarction." Ischemic stroke is "an infarction of central
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nervous system tissue" that may be symptomatic or silent. The other terms are not related to the
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new definitions.
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, 5. The term asteatosis refers to: t t t t
skin that is dry, flaky, rough, and often itchy
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Explanation:
Physiologic changes of aging include loss of elastic turgor, and wrinkling. Skin that appears dry,
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flaky, rough, and itchy is termed asteatosis. Sun exposure can cause damage to the skin
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resembling an appearance as weather beaten, thickened, yellowed, and deeply furrowed.
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Seborrheic keratosis appear as raised, yellowish lesions that feel greasy, velvety, or warty. Painful
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vesicular lesions in a dermatomal distribution may suggest herpes zoster.
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6. An enlarged liver with a smooth tender edge may suggest:
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right-sided heart failure. t t
Explanation:
An enlarged liver with a smooth, tender edge suggests inflammation, as in hepatitis, or venous
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congestion, as in right-sided heart failure. Cirrhosis, hematochromatosis (increased amount of iron
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in the blood), and lymphoma produce an enlarged liver with a firm, nontender edge. An enlarged
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liver that is firm or hard and has an irregular edge or surface suggests hepatocellular carcinoma.
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7. New onset hypertension with proteinuria or end-organ damage is:
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preeclampsia Explanation: t
Chronic hypertension occurs when systolic BP (SBP) >140 mm Hg or diastolic BP (DBP) >90 mm
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Hg documented prior to pregnancy, before 20 weeks, or beyond 12 weeks postpartum.
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Gestational hypertension refers to elevated blood pressure detected after 20 weeks gestation in the
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absence of proteinuria. Pre-eclampsia occurs in a woman who was previously normotensive but
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now has new onset hypertension with either proteinuria or end-organ damage. Primary
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hypertension, formerly known as essential hypertension, is a disorder which is associated with
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elevated blood pressure and an unidentifiable cause.
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8. The psoas muscle group and muscles of the abdominal wall assist with:
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flexion
Explanation:
The psoas muscle group and muscles of the abdominal wall assist with flexion. The deep intrinsic
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muscles of the back assist with extension. The abdominal muscles and intrinsic muscles of the back
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assist with rotation. Lateral bending uses the abdominal muscles and intrinsic muscles of the back.
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9. "Preterm small for gestational age" (SGA) infants are prone to: t t t t t t t t t
hypocalcemia
Explanation:
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"Preterm appropriate for gestational age" (AGA) infants are prone to respiratory distress syndrome,
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apnea, patent ductus arteriosus with left-to-right shunt, and infection. "Preterm small for
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gestational age" (SGA) infants are more likely to experience asphyxia, hypoglycemia, and
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hypocalcemia.
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, 10. Swelling noted 1-2 inches below the knee joint and on the medial surface of the t t t t t t t t t t t t t t
t knee would be suggestive of: t t t t
anserine bursitis t
Explanation:
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Swelling 1-2 inches below the knee joint and on the medial surface would be suggestive of
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anserine bursitis. Swelling over the tibial tubercle suggests infrapatellar bursitis. Swelling over
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the patella suggests prepatellar bursitis. Semimembranous bursitis would be suggested by
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swelling on the posterior and medial surface of the knee.
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11. A patient states that the only way he can sleep at night is to use several pillows or to
t t t t t t t t t t t t t t t t t t
t sleep upright in a recliner. This sleep pattern is most consistent with:
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obstructive lung disease Explanation: t t t
With obstructive lung disease, the patient experiences orthopnea, dyspnea that occurs when the
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patient lies down but improves with sitting. Therefore, the patient would use several pillows or
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sleep upright in a recliner. Orthopnea is seen in obstructive lung disease, mitral stenosis, and heart
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failure. Paroxysmal nocturnal dyspnea describe episodes of sudden dyspnea that cause the patient
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to awaken from sleep where the patient must sit up, walk, or stand for it to resolve. Coughing and
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wheezing may also occur. Angina pectoris commonly creates chest pain or shortness of breath.
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Jugular venous pressure reflects right atrial pressure and volume status. In cases of cardiac or
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pulmonary dysfunction, jugular venous pressures usually raise.
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12. A positive obturator sign would elicit pain in the:
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right hypogastric area t t
Explanation:
Assessment of the obturator sign is performed by flexing. By flexing the patient's right thigh at the
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hip with the knees bent, rotating the leg internally at the hip. If this causes increased pain in the right
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epigastric area, then the obturator sign is positive. Hypogastric pain occurs as the obturator muscle
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rubs an inflamed appendix.
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13. The lateral bone that serves as a strut between the scapula and the sternum is
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t known as the: t t
clavicle
Explanation:
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The lateral bone that serves as a strut between the scapula and the sternum is known as the clavicle.
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The humerus is the long bone of the upper arm. The acromion process is an extension of the spine of
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the scapula and located at the highest point of the shoulder. The thick curved extension of the
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superior border of the scapula is referred to as the coracoid process.
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14. When examining the foot of a patient, the nurse practitioner notes focal heel t t t t t t t t t t t t
t tenderness on palpation of the plantar fascia. This could be suggestive of: plantar t t t t t t t t t t t t
fasciitis
Explanation:
