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.

Answer and Explanation

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.

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Correct Answer is B

Explanation

Choice A rationale

A standing order is a pre-written medication order and protocol that applies to a specific patient population or clinical situation, allowing nurses to initiate treatment without immediate physician consultation. While it provides a framework, a daily medication is more specifically classified by its regular administration schedule, distinguishing it from general standing orders.

Choice B rationale

A routine order signifies a medication order that is carried out as prescribed until a discontinuation order or change is made. The medication is given on a regular, scheduled basis, often daily, multiple times a day, or weekly. This ensures consistent therapeutic levels for chronic conditions. Lasix 40 mg PO daily fits this description, as it is given consistently each day.

Choice C rationale

A STAT order (statim) means "immediately" and indicates that the medication must be administered as soon as possible, typically within 30 minutes of the order. This type of order is reserved for urgent situations where delay could significantly impact patient outcomes. Lasix ordered daily does not fall into this urgent category.

Choice D rationale

A PRN order (pro re nata) means "as needed.”. This type of order allows the nurse to administer medication based on the patient's symptoms or specific criteria rather than on a fixed schedule. Since Lasix is ordered "daily," it implies a fixed schedule, not an "as needed" administration.

A. In the groove behind the inner ankle. B. In the inguinal area. C. On top of the foot. D. Behind the knee.

Correct Answer is A

Explanation

Choice A rationale

The posterior tibial pulse is located in the groove between the medial malleolus (inner ankle bone) and the Achilles tendon. Palpating this pulse requires a gentle but firm touch to identify the arterial pulsations. It is a common site for assessing peripheral circulation and is essential for evaluating lower extremity perfusion.

Choice B rationale

The inguinal area is the anatomical region of the groin, where the femoral pulse is located. The femoral pulse is palpable just below the inguinal ligament, midway between the anterior superior iliac spine and the pubic symphysis. This is a central pulse site, distinct from the posterior tibial pulse.

Choice C rationale

The top of the foot is where the dorsalis pedis pulse is located. This pulse is found lateral to the extensor hallucis longus tendon, over the metatarsal bones. It is another important site for assessing lower extremity perfusion but is different from the posterior tibial pulse.

Choice D rationale

Behind the knee is the location for palpating the popliteal pulse. This pulse is more difficult to assess due to its deep location within the popliteal fossa. It requires the patient's knee to be slightly flexed to relax the muscles and facilitate palpation.

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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:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Complete the following using the list of options. The nurse is admitting a new client to the hall. While looking at the orders, she notes a medication order for Lasix 40 mg PO daily. The nurse knows that this is an example of?

Correct Answer is B

Explanation

The nurse is preparing to assess the posterior tibial pulse. Where is the correct location for palpation?

Correct Answer is A

Explanation

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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: