NR304 FINAL EXAM 2024 ACTUAL
EXAM COMPLETE EXAM QUESTIONS
AND CORRECT ANSWERS
arteries - ANSWERS active blood flow
veins - ANSWERS passive blood flow - do not have a pulse, returns to the heart via
movement through the skeletal muscles
femoral pulse site - ANSWERS groin
popliteal pulse site - ANSWERS back of knee
radial pulse site - ANSWERS Located at the wrist on the thumb side
dorsalis pedis pulse site - ANSWERS top of foot
posterior tibial pulse site - ANSWERS on medial surface of ankle near ankle bone
ischemia - ANSWERS Lack of blood supply, causes pain
necrosis - ANSWERS long term lack of blood supply, tissue death
axillary lymph nodes - ANSWERS located under the arms in the armpits
cervical lymph nodes - ANSWERS located along the sides of the neck
Epitrochlear lymph nodes - ANSWERS Epitrochlear lymph nodes- drains from the
hand and forearm
inguinal lymph nodes - ANSWERS located in the inguinal (groin) area of the lower
abdomen
Children and Lymph Nodes - ANSWERS nodes can be enlarged with no
pain/infection
Pregnancy and PV - ANSWERS dependent edema, varicose veins
peripheral artery disease - ANSWERS A form of peripheral vascular disease in
which there is partial or total blockage of an artery, usually one leading to a leg or
arm. 50% of cases are African Americans. RF: smoking, HTN, diabetes
intermittent claudication - ANSWERS when walking, muscle needs more O2 blood,
and you have any kind of occlusion, when walking pain is increased
Pulse Scale - ANSWERS 0: absent
1+: weak
2+: normal
,3+: increased, full, bounding
Allen test - ANSWERS determining the patency of the radial and ulnar arteries by
compressing one artery site and observing return of skin color as evidence of
patency of the other artery, determine if radial artery has been damaged, press radial
artery then see if ulnar artery perfuses to hand
venous ulcers - ANSWERS bleed, medial malleolus
arterial (ischemic) ulcers - ANSWERS does not bleed, has a necrotic black crust,
lateral malleolus
neuropathic ulcer - ANSWERS destroys nerve endings, burning pain/numbness
Edema Scale - ANSWERS • 1+ Mild pitting, slight indentation, no perceptible
swelling of the leg
• 2+ Moderate pitting, indentation, subsides rapidly
• 3+ Deep pitting, indentation remains for a short time, leg looks swollen
• 4+ Very deep pitting, indentation lasts a long time, leg is very swollen
Doppler ultrasound - ANSWERS determine location of pulse
Raynaud's disease - ANSWERS autoimmune, sporadic vasoconstriction then
relaxation, happens in hands/toes usually
Lymphadema - ANSWERS enlarged lymph nodes, hard edema
Varicose veins - ANSWERS abnormally swollen, twisted veins with defective
valves; most often seen in the legs
DVT - ANSWERS inflammatory process, swelling, redness, heat, pain, happens
from venastasis, pooling of blood in calf
-tachycardia, low grade temp
-women on birth control who smoke are at a higher risk, and also those who are
dehydrated since blood is more viscous
-Do not perform homan's sign test (flexing foot back)
anneurysm - ANSWERS can be born with or develop, serious with abdominal
aorta/coronary arteries/brain
Decreased Arterial Flow - ANSWERS doesn't work well around gravity, blue then
pallor
Decreased Venous Flow - ANSWERS brown, using muscles improves
What happens when valves of the veins do not work right - ANSWERS
edema/varicose veins
arterial insufficiency - ANSWERS not getting enough arterial blood flow = ischemic
pain, usually happens on one leg, leg appears shiny, hairless, red/blue then pallor,
,limb gets cool, pain gets better when resting since the limb doesn't need as much O2
blood flow (intermittent claudication), gravity works for it when legs are down, causes
impotence in males, can affect nails/toes
venous insufficiency - ANSWERS constant, achy, fullness, pain. Pain gets better by
moving. When you stand/sit pain gets worse. Gravity works against when legs are
down. Usually happens on both legs, skin turns red/brown, starts below the knee to
the ankle, skin is scaly, can get slits in skin (weeping edema), there is no cure, no
change in skin temp.
pulse - ANSWERS rhythm, rate, symmetry, amplitude/strength
arterial occlusion - ANSWERS -extreme coolness
-pain
-loss of sensation
-hair loss and skin changes
-pallor
-pulselessness
arterial insufficiency - ANSWERS -intermittent claudation (pain brought on by
exercise and relieved with rest)
-hair loss on toes and shiny skin
-impotence
-pain (gnawing, sharp or stabbing and increases with exercise, relieved with rest)
-decreased pulses
-rusty discoloration due to blood leaking out of vessel and difficulty being reabsorbed
-skin ulcers on pressure points, toes, and lateral malleoli
-necrosis
-bluish/red feet with dependence and pallor with elevation
-sensory and motor loss
-thickened, yellow toenails
-cool skin
venous insufficiency - ANSWERS -pitting edema due to fluid leaking into tissue due
to incompetent valves
-pain (aching or feeling of fullness and increases with standing/sitting and improves
with elevating legs or walking)
-varicosities may be present
-possible leg ulcers on medial malleoli
-normal temperature
-skin thickened with brown discoloration of ankles and flaky
deep vein thrombosis - ANSWERS -edema (only on one leg)
-pain - no pain or sharp, intense pain/tenderness
-red skin area
-warmth
-mass
-low grade fever
-tachycardia
, Peripheral Neuropathy - ANSWERS -burning skin
-numbness
-loss/decreased sensation
GERD - ANSWERS (pyrosis) - failure of pyloric valve, dont eat before bed or in
middle of night, dont lie down after eating for at least 30 mins
What causes peptic ulcers? - ANSWERS H. pylori - loves acid
Small Bowel - ANSWERS -small in diameter, huge in length 20ft
-where most digestion/breakdown ocurrs
-where enzymes from pancreas go
-most of absorption of nutrients ocurrs
large bowel - ANSWERS -shorter but larger diameter
-condense stool into formed stool (pulls water out)
-where you metabolize fats to absorb vit. D
E.coli - ANSWERS -essential bacteria that breaks down food in bowel
-if it is any other placer than the gut, it can kill you
-in wound = infection
-bladder = UTI
-lungs = dangerous pneumonia
C. Diff - ANSWERS -if you take antibiotics you kill e.coli in gut, so you have an
overgrowth of other microbes (importance of probiotics)
-when you kill all this bacteria you get C.diff - terrible bacteria that can kill you
-explosive diarrhea, highly contagious, gown/glove precautions, horrible smell
-can prevent C. Diff by probiotics - can have yogurt with live cultures or need
probiotic with 50 million bacteria
Peristalsis - ANSWERS Involuntary waves of muscle contraction that keep food
moving along in one direction through the digestive system.
hyperactive peristalsis - ANSWERS diarrhea
slowed peristalsis - ANSWERS constipation, any type of narcotic slows peristalsis a
lot and can even cause a bowel obstruction/impaction
-prevention: have pt. take a stool softener with pain pill
-anesthesia, immobility, and dehydration can also slow peristalsis
Ileostomy - ANSWERS removal of part of small bowel, can lead to malnutrition
Colostomy - ANSWERS removal of part of large bowel, reversible
hernia - ANSWERS protrusion of an organ or part through the tissues and muscles
normally containing it
chron's disease - ANSWERS autoimmune, destroying parts of lining of bowel,
nutritionally depleted, anemia from bleeding
