When auscultating over a patient's carotid arteries, the nurse notices the presence of a bruit on the left side.
The nurse knows that bruits:
Occur in the presence of lymphadenopathy.
Are caused by hypermetabolic states.
Occur with turbulent blood flow, indicating partial occlusion.
Are often associated with venous disease.
The Correct Answer is C
Choice A rationale
Lymphadenopathy refers to enlarged lymph nodes, which are palpable structures of the immune system. Bruits are vascular sounds, specifically turbulent blood flow, and are entirely unrelated to the presence or size of lymph nodes. Lymphadenopathy indicates an immune response or lymphatic system issue, whereas bruits indicate arterial pathology.
Choice B rationale
Hypermetabolic states, such as hyperthyroidism, can increase cardiac output and blood flow velocity, potentially leading to flow murmurs in the heart. However, they do not directly cause bruits in the carotid arteries. Carotid bruits are typically indicative of localized arterial narrowing or disease, not a systemic increase in metabolism.
Choice C rationale
Bruits are audible vascular sounds, often described as a "whooshing" or "swishing" sound, that result from turbulent blood flow through a narrowed or partially occluded artery. In the carotid arteries, a bruit strongly suggests atherosclerotic plaque formation, which reduces the arterial lumen and disrupts the smooth, laminar flow of blood, creating turbulence.
Choice D rationale
Bruits are arterial sounds, reflecting turbulence within arteries. Venous disease primarily involves veins, and while some venous conditions like arteriovenous fistulas can produce continuous murmurs, typical bruits heard over carotid arteries are characteristic of arterial narrowing and compromise, not venous pathology. Venous hums can occur but are distinctly different from arterial bruits.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
A positive Romberg sign is indicated when a patient, asked to stand with feet together and arms at their side with eyes closed, sways significantly or loses balance. This suggests a deficit in proprioception, which is the sense of one's body position in space, as visual input cannot compensate for the impaired proprioceptive feedback to maintain equilibrium.
Choice B rationale
Homans' sign is a clinical indicator for deep vein thrombosis (DVT), assessed by dorsiflexing the foot and observing for calf pain. A negative Homans' sign means no pain is present, and it is unrelated to balance or coordination assessment.
Choice C rationale
Lack of coordination is a general term that could encompass various motor deficits, but "ataxia" is a more specific neurological term for impaired coordination. While swaying and moving feet apart demonstrate a lack of coordination, documenting it as a positive Romberg sign provides a more precise and diagnostically relevant finding in this specific context.
Choice D rationale
Ataxia refers to impaired coordination of voluntary movements, often appearing as clumsiness, inaccuracy, or instability. While the patient's actions exhibit ataxia, the specific maneuver performed (standing with eyes closed) and the resulting sway are characteristic of a positive Romberg sign, which points to a proprioceptive or vestibular deficit.
Correct Answer is A
Explanation
Choice A rationale
A tuning fork is a U-shaped instrument that, when struck, produces a specific frequency of vibration. In audiology, it is used to assess both air conduction (sound transmitted through the external and middle ear to the inner ear) and bone conduction (sound transmitted directly to the inner ear through the skull), aiding in differentiating types of hearing loss.
Choice B rationale
A penlight is a small, handheld light source primarily used for illuminating body cavities, assessing pupillary reflexes, or examining the oral cavity and throat. It does not produce sound vibrations and is not used for measuring air or bone conduction in the ear.
Choice C rationale
A reflex hammer is an instrument used to elicit deep tendon reflexes by tapping on tendons, stretching the muscle, and activating the reflex arc. It is a neurological assessment tool and has no function in measuring auditory conduction.
Choice D rationale
An otoscope is a medical device equipped with a light and magnifying lens, used for visual examination of the external ear canal and tympanic membrane (eardrum). While essential for ear assessment, it does not measure air or bone conduction; rather, it allows for direct visualization of anatomical structures.
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