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2024 NR304 Health Care Assessment Practice Exam With Answers (225 Solved Questions)

2024 NR304 Health Care Assessment Practice Exam With Answers provides access to real exam questions and answers, offering you the practice you need to succeed.

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    NR 304/ NR304 Health Assessment Exam Latest 2024 With Verified Solutions peripheral artery disease (PAD) - Common circulatory problem in which narrowed arteries reduce blood flow to limbs -affects non-coronary arteries -blood flow can't match muscle demand during exercise signs & symptoms of PAD - painful cramping after certain activities leg numbness/weakness coldness lower leg & foot shiny skin/no hair on legs no pulse/weak pulse in legs & foot non-healing sores on toes, feet, leg change color legs hair loss/distribution changes causes of PAD - atherosclerosis risk factors for PAD - smoking diabetes mellitus kidney disease high BP high cholesterol >50 yrs old obesity sedentary lifestyle African American first sign of PAD - intermittent claudation signs of advanced PAD - burning/aching pain in feet & toes while resting cool skin redness/other skin color changes

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    foot ulcers hypovolemic shock - emergency situation which severe blood or fluid loss makes heart unable pump enough blood to body -can cause organ failure causes of hypovolemic shock - bleeding burns diarrhea excessive perspiration vomiting signs & symptoms of hypovolemic shock - major blood loss rapid heartbeat (tachycardia) quick, shallow breathing fatigue/weakness confusion little - no urine output low BP cool, clammy skin deep vein thrombosis (DVT) - blood clot (thrombus) forms in a large vein, usually in a lower limb -if swells = thrombophlebitis risk factors for DVT - prolonged bed-rest immobility heart failure obesity varicose veins used to determine severity of DVT - wells score -1 to 2: moderate -3+: high

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    signs & symptoms of DVT - aching calf pain/lower leg pain -worse at end of day/prolonged siting or standing itching w/ stasis dermatits lower leg edema unresolved w/ diuretic therapy -firm & brawny coarse, thickened skin normal pulse brown pigment discoloration petichea venous stasis = increased venous pressure/RBC leakage expected vital signs of 2 month old infant - -reverse order: respirations, pulse then temperature -temperature = rectal *probe no further 1 in. *normally higher than older ages (~100 degrees) -pulse = apical rate *fluctuates more in response to illness & emotions *awake ~100-190 *asleep ~90-160 -respirations = count 1 full minute *more diaphragmatic than thoracic *sleeping rate more accurate *tachypnea = >60/min (indication of infection/fever) *~30-53 breaths/min -BP = electronic device or doppler ultrasound *smaller arm vessels = harder hear korotkoff sounds *~72-104/37-53 chronic obstructive pulmonary disease (COPD) - group lung diseases block airflow making it difficult to breathe -most common = emphysema & chronic bronchitis

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    -damage to lungs irreversible signs & symptoms of COPD - wheezing shortness of breath (SOB) barrel chest decreased breath sounds clubbing paradoxical pulse hemoptysis cyanosis weight loss w/ malignancy lack energy lower extremity edema use of accessory muscles to breath cough w/ increased sputum production periods of exaccerbation common health history w/ COPD - tobacco use diagnostic tests for COPD - peak flow incentive spirometry chest x-ray pulmonary function test (PFT) contact dermatitis (primary) - local inflammatory reaction to irritant in environment or allergen -signs/symptoms erythema swelling wheals (urticaria) maculopapular vesicles scales intense pruritis -ex: poison ivy

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    contact dermatitis (red rash) - history skin contact w/ allergen in environment intense pruritis primary lesion = red swollen vesicle weeping lesions, crusts, scales, thickening skin excoiations from scratching ex: reaction from feminine hygiene spray Pursed-lip breathing (PLB) - a technique of exhaling against pursed lips to prolong exhalation, preventing bronchiolar collapse and air trapping done to increase expiratory airway pressure, improve oxygenation of the blood, and help prevent early airway closure moving air takes less work used to detect COPD emphysema - destruction pulmonary connective tissue characterized by permanent enlargement air sacs distal to terminal bronchioles & rupture interaveolar walls -increases airway resistance signs & symptoms of emphysema - increased AP diameter barrel chest use accessory muscles short of breath (esp. upon excretion) hyperresonant decreased diaphragmatic excursion respiratory distress tachypnea decreased tactile fermitus decreased chest expansion decreased breath sounds prolonged expiration

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    chronic bronchitis - proliferation mucus glands in passageways resulting excessive mucus secretions -caused by cigarette smoking signs & symptoms of chronic bronchitis - hacking,rasping cough w/ productive, thick mucoid sputum normal tactile fermitus resonant percussion crackles over deflated area dyspnea fatigue cyanosis possible clubbing prolonged expiration normal lung sounds - bronchial (tracheal) bronchovesicular vesicular bronchial (tracheal) sounds - high pitched, loud, harsh/hollow tubular normally heard over trachea & larynx heard more on expiration heard anteriorly bronchovesicular breath sounds - moderate pitch & amplitude w/ mixed quality heard over major bronchi (fewer alveolar located) -between scapula (posteriorly) -upper sternum 1st/2nd intercostal space (anteriorly) inspiration = expiration vesicular breath sounds - low pitched, soft amplitude, rustling like wind in trees inspiration > expiration heard all over lung fields

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    -where airflow through smaller bronchioles/alveoli Abnormal (Adventitious) Lung Sounds - crackles and wheezes and stridor fine crackles (rales) - discontinuous, high-pitched, short cracking/popping heard during inspiration not cleared by cough inspiratory = explosive coarse crackles (rales) - loud, low-pitched bubbling/gurgling starts early inspiration -may be present in expiration may decrease by suctioning/coughing but reappear shortly after sounds like unfastening velcro ex: pulmonary edema, pulmonary fibrosis, pneumonia atelectatic crackles (rales) - like fine crackles but shorter not pathologic disappear after first few breaths heard in axillae/base lungs -when secretions re-expand w/ few deep breaths ex: bedridden patient or older adult just waking up pleural friction rub - superficial, coarse, low-pitched sound grating quality heard anterolateral wall = greatest lung mobility ex: pluritis high-pitched wheeze (sibilant) - musical squeaking sound (polyphonic) air squeezed through narrowed passageway oscillating walls ex: diffuse airway obstruction from acute asthma ex: chronic emphysema low-pitched wheeze (sonorous rhonchi) - monophonic (single note)

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