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

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NR 304/ NR304 Health Assessment Exam Latest 2024 With Verified Solutionsperipheral artery disease (PAD) - Common circulatory problem in which narrowed arteriesreduce blood flow to limbs-affects non-coronary arteries-blood flow can't match muscle demand during exercisesigns & symptoms of PAD - painful cramping after certain activitiesleg numbness/weaknesscoldness lower leg & footshiny skin/no hair on legsno pulse/weak pulse in legs & footnon-healing sores on toes, feet, legchange color legshair loss/distribution changescauses of PAD - atherosclerosisrisk factors for PAD - smokingdiabetes mellituskidney diseasehigh BPhigh cholesterol>50 yrs oldobesitysedentary lifestyleAfrican Americanfirst sign of PAD - intermittent claudationsigns of advanced PAD - burning/aching pain in feet & toes while restingcool skinredness/other skin color changes

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foot ulcershypovolemic shock - emergency situation which severe blood or fluid loss makes heartunable pump enough blood to body-can cause organ failurecauses of hypovolemic shock - bleedingburnsdiarrheaexcessive perspirationvomitingsigns & symptoms of hypovolemic shock - major blood lossrapid heartbeat (tachycardia)quick, shallow breathingfatigue/weaknessconfusionlittle - no urine outputlow BPcool, clammy skindeep vein thrombosis (DVT) - blood clot (thrombus) forms in a large vein, usually in a lowerlimb-if swells = thrombophlebitisrisk factors for DVT - prolonged bed-restimmobilityheart failureobesityvaricose veinsused 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 standingitching w/ stasis dermatitslower leg edema unresolved w/ diuretic therapy-firm & brawnycoarse, thickened skinnormal pulsebrown pigment discolorationpeticheavenous stasis = increased venous pressure/RBC leakageexpected vital signs of 2 month old infant - -reverse order: respirations, pulse thentemperature-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*~72-104/37-53chronic obstructive pulmonary disease (COPD) - group lung diseases block airflow making itdifficult to breathe-most common = emphysema & chronic bronchitis

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-damage to lungs irreversiblesigns & symptoms of COPD - wheezingshortness of breath (SOB)barrel chestdecreased breath soundsclubbingparadoxical pulsehemoptysiscyanosisweight loss w/ malignancylack energylower extremity edemause of accessory muscles to breathcough w/ increased sputum productionperiods of exaccerbationcommon health history w/ COPD - tobacco usediagnostic tests for COPD - peak flowincentive spirometrychest x-raypulmonary function test (PFT)contact dermatitis (primary) - local inflammatory reaction to irritant in environment orallergen-signs/symptomserythemaswellingwheals (urticaria)maculopapular vesiclesscalesintense pruritis-ex: poison ivy

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contact dermatitis (red rash) - history skin contact w/ allergen in environmentintense pruritisprimary lesion = red swollen vesicleweeping lesions, crusts, scales, thickening skinexcoiations from scratchingex: reaction from feminine hygiene sprayPursed-lip breathing (PLB) - a technique of exhaling against pursed lips to prolongexhalation, preventing bronchiolar collapse and air trappingdone to increase expiratory airway pressure, improve oxygenation of the blood, and helpprevent early airway closuremoving air takes less workused to detect COPDemphysema - destruction pulmonary connective tissue characterized by permanentenlargement air sacs distal to terminal bronchioles & rupture interaveolar walls-increases airway resistancesigns & symptoms of emphysema - increased AP diameterbarrel chestuse accessory musclesshort of breath (esp. upon excretion)hyperresonantdecreased diaphragmatic excursionrespiratory distresstachypneadecreased tactile fermitusdecreased chest expansiondecreased breath soundsprolonged expiration

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chronic bronchitis - proliferation mucus glands in passageways resulting excessive mucussecretions-caused by cigarette smokingsigns & symptoms of chronic bronchitis - hacking,rasping cough w/ productive, thick mucoidsputumnormal tactile fermitusresonant percussioncrackles over deflated areadyspneafatiguecyanosispossible clubbingprolonged expirationnormal lung sounds - bronchial (tracheal)bronchovesicularvesicularbronchial (tracheal) sounds - high pitched, loud, harsh/hollow tubularnormally heard over trachea & larynxheard more on expirationheard anteriorlybronchovesicular breath sounds - moderate pitch & amplitude w/ mixed qualityheard over major bronchi (fewer alveolar located)-between scapula (posteriorly)-upper sternum 1st/2nd intercostal space (anteriorly)inspiration = expirationvesicular breath sounds - low pitched, soft amplitude, rustling like wind in treesinspiration > expirationheard all over lung fields

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-where airflow through smaller bronchioles/alveoliAbnormal (Adventitious) Lung Sounds - crackles and wheezes and stridorfine crackles (rales) - discontinuous, high-pitched, short cracking/poppingheard during inspirationnot cleared by coughinspiratory = explosivecoarse crackles (rales) - loud, low-pitched bubbling/gurglingstarts early inspiration-may be present in expirationmay decrease by suctioning/coughing but reappear shortly aftersounds like unfastening velcroex: pulmonary edema, pulmonary fibrosis, pneumoniaatelectatic crackles (rales) - like fine crackles but shorternot pathologicdisappear after first few breathsheard in axillae/base lungs-when secretions re-expand w/ few deep breathsex: bedridden patient or older adult just waking uppleural friction rub - superficial, coarse, low-pitched soundgrating qualityheard anterolateral wall = greatest lung mobilityex: pluritishigh-pitched wheeze (sibilant) - musical squeaking sound (polyphonic)air squeezed through narrowed passageway oscillating wallsex: diffuse airway obstruction from acute asthmaex: chronic emphysemalow-pitched wheeze (sonorous rhonchi) - monophonic (single note)

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