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1. c. The relationship of symptoms and a specific trigger such as physical exerciseCOPD clients have low oxygen and high carbon dioxide levels. Therefore, hypoxia is the

main stimulus for ventilation is persons with chronic hypercapnea. Increasing the level ofoxygen would decrease the stimulus to breathe.

2. d. persistent changing coughThe most common sign of lung cancer is a persistent cough that changes. Other signs aredyspnea, bloody sputum and long term pulmonary infection. Option A is common with

asthma, option B is common with COPD and option C is common with TB.

3. c. ischemiaDepressed ST segment and inverted T-waves represent myocardial ischemia. Injury has aST segment elevation.

4. a. promote healingSitz bath provides moist heat to the perineal and anal area to clean, promote healing anddrainage and reduce soreness to the area. Sitz bath helps healing with cleaning action and

promotion of circulation, thereby reducing swelling. Sitz bath usually has no therapeutic

value in lowering body temperature. Although relief of tension can occur, this effect is

secondary to the promotion of healing.

5. b. hypocalcemiaTrousseaus sign is a carpal pedal spasm elicited when a blood pressure cuff is inflated onthe arm of a patient with hypocalcemia.

6. c. meningitisA patient with meningitis will exhibit signs that include photophobia and nuchal rigidity,which is pain on the flexion of the chin to chest.

7. c. female over 55 years of ageLifestyle, cigarette smoking and hyperlipidemia can be changed by changing behaviors.

8. d. AneurysmThe symptoms exhibited by the client are typical of an abdominal aortic aneurysm. Themost significant sign is the audible pulse in the abdominal area. If hemorrhage were

present, the abdomen would be tender and firm.

9. b. Relaxing smooth muscle to avoid vasospasmsThe major task of the health care team is to medicate the client drugs that produce smooth

muscle relaxation, which will decrease the vasospasm and increase the arterial flow to theaffected part. The drugs used are calcium antagonists.

10. d. urinary catheter patencyThe patient is complaining of symptoms of autonomic dysreflexia, which consists of the triad

of hypertension, bradycardia and a headache. Major causes of autonomic dysreflexia includeurinary bladder distention and fecal impaction. Checking the patency of the urinary catheter

will check for bladder distention.

11. c. Huntingtons diseaseHuntingtons disease is a hereditary disease in which degeneration of the basal ganglia andcerebral cortex causes chronic progressive chorea (muscle twitching) and mentaldeterioration, ending in dementia. Huntingtons disease usually strikes people ages 25 to

55.

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12. d. metabolic alkalosisMs. Hizons pH is above 7.45, which makes it alkalatic, and her bicarbonate is high which isalso makes it basic. Thus, the diagnosis is metabolic alkalosis.

13. b. hold an objectThe resting or non-intentional tremor may be controlled with purposeful movement such asholding an object. A warm bath, deep breathing and diazepam will promote relaxation but

are not specific interventions for tremor.

14. a. Parkinsons diseaseA shuffling gait from the musculoskeletal rigidity of the patient with Parkinsons disease iscommon. Patients experiencing a stroke usually exhibit loss of voluntary control over motor

movements associated with generalized weakness; a shuffling gait is usually not observed

in stroke patient.

15. c. a ventilator on stand byAlthough a ventilator is not required for injury below C3, the innervation of intercostal

muscles is affected. Hemorrhage and cord swelling extends the level of injury making it

likely that this client will need a ventilator.

16. b. protein deficiencyProtein deficiency allows fluid to leak out of the vascular system and third space into thetissues and spaces in the body such as the peritoneal space. Bleeding tendencies,

dehydration and vitamin deficiency can occur but dont cause ascites.

17. d. Swan neck deformitiesSwan neck deformities of the hand are classic deformities associated with rheumatoid

arthritis secondary to the presence of fibrous connective tissue within the joint space.Clients with RA do experience morning stiffness, but it can last from 30 minutes up toseveral hours. RA is characterized by symmetrical joint movement, and heberdens nodes

are characteristic of osteoarthritis.

18. c. an auraAn aura frequently precedes an epileptic seizure and may manifest as vague physic

discomfort or specific aromas. Patients experiencing auras arent having a CVA, substancewithdrawal or hallucination.

19. b. laryngeal cancerThese symptoms, along with dysphagia, foul-smelling breath, and pain when drinking hot oracidic, are common signs of laryngeal cancer.

20. a. these symptoms are consistent with an ulcerThe description of pain is consistent with ulcer pain. The pain is epigastric and is worse

when the stomach is empty and is relived by food.

21. c. The liver affected by cirrhosis is unable to produce clotting factors.When bile production is reduced, the body has reduced ability to absorb fat-soluble

vitamins. Without adequate Vitamin K absorption, clotting factors II, VII, IX, and X are not

produced in sufficient amounts.

22. a. excruciating, intermittent, paroxysmal facial pain

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Trigeminal neuralgia is a syndrome of excruciating, intermittent, paroxysmal facial pain. It

manifests as intense, periodic pain in the lips, gums, teeth or chin. The other symptoms

arent characteristic of trigeminal neuralgia.

23. d. Assess for respiratory distressThough fluid volume status, neurological status and pain are all important assessment, the

immediate priority for postoperative is the airway management. Respiratory distress mayresult from hemorrhage, edema, laryngeal damage or tetany.

24. b. Emollients and moisturizers to soften scalesEmollients will ease dry skin that increases pruritus and causes psoriasis to be worse.

Washing and drying the skin with rough linens or pressure may cause excoriation. Constantocclusion may increase the effects of the medication and increase the risk of infection.

25. c. Pulse 40 with inspirationParadoxical pulse is a hallmark symptom of cardiac tamponade. As pressure is exerted onthe left ventricle from fluid, the natural increase in pressure from the right ventricle during

inspiration creates even more pressure, diminishing cardiac output.